Treatment of acute sciatica with transforaminal epidural corticosteroids and local anesthetic: design of a randomized controlled trial

• Published in: BMC musculoskeletal disorders 2017-05, Vol.18 (1), p.215-215, Article 215
• Main Authors: Ter Meulen, Bastiaan C, Maas, Esther T, Vyas, Amrita, van der Vegt, Marinus, de Priester, Koo, de Boer, Michiel R, van Tulder, Maurits W, Weinstein, Henry C, Ostelo, Raymond W J G
• Format: Article
• Language: English
• Subjects: Acute Disease; Adrenal Cortex Hormones - administration & dosage; Analgesics; Anesthetics, Local - administration & dosage; Bupivacaine - administration & dosage; Bupivacaine - analogs & derivatives; Corticosteroids; Drug therapy; Drug Therapy, Combination; Economic evaluation; Epidural injections; Humans; Injections, Epidural; Intervertebral Disc Displacement - complications; Intervertebral Disc Displacement - diagnostic imaging; Intervertebral Disc Displacement - drug therapy; Lumbar disc herniation; Prospective Studies; Randomized controlled trial; Sciatica; Sciatica - diagnostic imaging; Sciatica - drug therapy; Sciatica - etiology; Single-Blind Method; Study Protocol; Testing; Transforaminal epidural steroids; Treatment Outcome
• ISSN: 1471-2474; 1471-2474
• DOI: 10.1186/s12891-017-1571-8

Transforaminal epidural injections with steroids (TESI) are used increasingly for patients with sciatica. However there is much debate about their safety and effectiveness. It is important to identify patients that benefit most from TESI and only few trials have yet evaluated the effects in patients with acute sciatica. We describe a prospective, randomized controlled trial (RCT), with the aim to evaluate the hypothesis that TESI plus Levobupivacaine (TESI-plus) added to oral pain medication is more effective compared to pain medication alone or compared to transforaminal injection with a local anesthetic of short duration among patients with acute sciatica. We will recruit a total of 264 patients with sciatica (