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The impact of epidural steroid injections on the outcomes of patients treated for lumbar disc herniation: a subgroup analysis of the SPORT trial - Spinal DISC Center | Kris Radcliff, MD | New Jersey
Dr. Kris Radcliff specializes in simplifying the management of complex spine conditions and traumatic spine injuries, focusing exclusively on spine surgery, with particular expertise in the area of artificial disc replacement. Dr. Radcliff is highly experienced, having performed more than 10,000 spine surgeries. He combines conservative decision-making judgment with state-of-the-art and minimally invasive surgical techniques, endoscopic spine surgery, and artificial disc replacement.
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The impact of epidural steroid injections on the outcomes of patients treated for lumbar disc herniation: a subgroup analysis of the SPORT trial

Kristen Radcliff, Alan Hilibrand, Jon D Lurie, Tor D Tosteson, Lawrence Delasotta, Jeffrey Rihn, Wenyan Zhao, Alexander Vaccaro, Todd J Albert, James N Weinstein: The impact of epidural steroid injections on the outcomes of patients treated for lumbar disc herniation: a subgroup analysis of the SPORT trial. In: J Bone Joint Surg Am, vol. 94, no. 15, pp. 1353–1358, 2012, ISSN: 1535-1386.

Abstract

BACKGROUND: The Spine Patient Outcomes Research Trial (SPORT) is a prospective, multicenter study of operative versus nonoperative treatment of lumbar intervertebral disc herniation. It has been suggested that epidural steroid injections may help improve patient outcomes and lower the rate of crossover to surgical treatment.

METHODS: One hundred and fifty-four patients included in the intervertebral disc herniation arm of the SPORT who had received an epidural steroid injection during the first three months of the study and no injection prior to the study (the ESI group) were compared with 453 patients who had not received an injection during the first three months of the study or prior to the study (the No-ESI group).

RESULTS: There was a significant difference in the preference for surgery between groups (19% in the ESI group compared with 56% in the No-ESI group, p < 0.001). There was no difference in primary or secondary outcome measures at four years between the groups. A higher percentage of patients changed from surgical to nonsurgical treatment in the ESI group (41% versus 12% in the No-ESI, p < 0.001).

CONCLUSIONS: Patients with lumbar disc herniation treated with epidural steroid injection had no improvement in short or long-term outcomes compared with patients who were not treated with epidural steroid injection. There was a higher prevalence of crossover to nonsurgical treatment among surgically assigned ESI-group patients, although this was confounded by the increased baseline desire to avoid surgery among patients in the ESI group. Given these data, we concluded that more studies are necessary to establish the value of epidural steroid injection for symptomatic lumbar intervertebral disc herniation.

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@article{pmid22739998,
title = {The impact of epidural steroid injections on the outcomes of patients treated for lumbar disc herniation: a subgroup analysis of the SPORT trial},
author = {Kristen Radcliff and Alan Hilibrand and Jon D Lurie and Tor D Tosteson and Lawrence Delasotta and Jeffrey Rihn and Wenyan Zhao and Alexander Vaccaro and Todd J Albert and James N Weinstein},
doi = {10.2106/JBJS.K.00341},
issn = {1535-1386},
year  = {2012},
date = {2012-08-01},
urldate = {2012-08-01},
journal = {J Bone Joint Surg Am},
volume = {94},
number = {15},
pages = {1353--1358},
abstract = {BACKGROUND: The Spine Patient Outcomes Research Trial (SPORT) is a prospective, multicenter study of operative versus nonoperative treatment of lumbar intervertebral disc herniation. It has been suggested that epidural steroid injections may help improve patient outcomes and lower the rate of crossover to surgical treatment.

METHODS: One hundred and fifty-four patients included in the intervertebral disc herniation arm of the SPORT who had received an epidural steroid injection during the first three months of the study and no injection prior to the study (the ESI group) were compared with 453 patients who had not received an injection during the first three months of the study or prior to the study (the No-ESI group).

RESULTS: There was a significant difference in the preference for surgery between groups (19% in the ESI group compared with 56% in the No-ESI group, p < 0.001). There was no difference in primary or secondary outcome measures at four years between the groups. A higher percentage of patients changed from surgical to nonsurgical treatment in the ESI group (41% versus 12% in the No-ESI, p < 0.001).

CONCLUSIONS: Patients with lumbar disc herniation treated with epidural steroid injection had no improvement in short or long-term outcomes compared with patients who were not treated with epidural steroid injection. There was a higher prevalence of crossover to nonsurgical treatment among surgically assigned ESI-group patients, although this was confounded by the increased baseline desire to avoid surgery among patients in the ESI group. Given these data, we concluded that more studies are necessary to establish the value of epidural steroid injection for symptomatic lumbar intervertebral disc herniation.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
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