HOME
pISSN 2005-9159
eISSN 2093-0569

Original Article

Korean J Pain 2020; 33(2): 192-198

Published online April 1, 2020 https://doi.org/10.3344/kjp.2020.33.2.192

Copyright © The Korean Pain Society.

Comparing pain relief and functional improvement between methylprednisolone and dexamethasone lumbosacral transforaminal epidural steroid injections: a self-controlled study

Nicholas K. Donohue1 , Sergey S. Tarima2 , Matthew J. Durand1,3 , Hong Wu1,4

1Department of Physical Medicine & Rehabilitation, Medical College of Wisconsin, Milwaukee, WI, USA
2Division of Biostatistics, Medical College of Wisconsin, Milwaukee, WI, USA
3Cardiovascular Center, Medical College of Wisconsin, Milwaukee, WI, USA
4Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI, USA

Correspondence to:Nicholas K. Donohue
Department of Physical Medicine & Rehabilitation, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA
Tel: +1-414-805-7342
Fax: +1-414-805-7919
E-mail: nkdonohue@mcw.edu

Received: February 7, 2020; Revised: March 5, 2020; Accepted: March 6, 2020

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: Previous studies have shown varying results between lumbosacral transforaminal epidural steroid injections (TFESIs) performed with particulate versus non-particulate corticosteroids. The purpose of this study was to investigate the difference in pain relief and functional improvement between particulate and non-particulate lumbosacral TFESIs in patients who had undergone both injections, sequentially.
Methods: This was a self-controlled, retrospective study of 20 patients who underwent both a methylprednisolone and a dexamethasone TFESI to the same vertebral level and side. Primary outcomes included pain relief according to the visual analogue scale (VAS) and functional improvement determined by a yes/no answer to questions regarding mobility and the activities of daily living. Post-injection data was recorded at 2, 3, and 6 months.
Results: A decrease in VAS scores of –3.4 ± 3.0 (mean ± standard deviation), –3.1 ± 3.1, and –2.8 ± 3.4 was seen for the methylprednisolone group at 2, 3, and 6 months, respectively. Similar decreases of –3.9 ± 3.5, –3.4 ± 2.8, and –2.3 ± 3.4 were seen in the dexamethasone group. There was no significant difference in pain relief at any point between the two medications. The percentage of subjects who reported improved function at 2, 3, and 6 months was 65%, 51%, and 41%, respectively, for the methylprednisolone group and 75%, 53%, and 42% for the dexamethasone group.
Conclusions: These findings support the use of non-particulate corticosteroids for lumbosacral TFESIs in the context of documented safety concerns with particulate corticosteroids.

Keywords: Adrenal Cortex Hormones, Dexamethasone, Injections, Epidural, Low Back Pain, Lumbosacral Region, Methylprednisolone, Pain Management, Radiculopathy, Steroids.