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Effectiveness of Bilateral Transforaminal Epidural Steroid Injections in Degenerative Lumbar Spinal Stenosis Sufferers With Neurogenic Claudication: A Case Collection.

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Effectiveness of Bilateral Transforaminal Epidural Steroid Injections in Degenerative Lumbar Spinal Stenosis Sufferers With Neurogenic Claudication: A Case Collection.

PM R. 2017 Jan;9(1):26-31

Authors: Farooque M, Salzman MM, Ye Z

Summary
BACKGROUND: As our inhabitants ages, neurogenic claudication (NC) from central canal stenosis of the lumbar backbone is turning into an more and more frequent situation. Research have been undertaken to evaluate the efficacy of caudal, interlaminar, or unilateral transforaminal epidural injections, however bilateral transforaminal epidural injections (BTESIs) haven’t been evaluated up to now.
OBJECTIVE: To evaluate the therapeutic worth and long-term results of fluoroscope-guided BTESIs in sufferers with NC from degenerative lumbar spinal stenosis (DLSS) of the central spinal canal.
DESIGN: Case collection.
SETTING: Single establishment backbone clinic.
PATIENTS: Twenty-six adults between the ages of 40 and 90 years with a prognosis of DLSS and a historical past of subacute or persistent NC.
METHODS/INTERVENTIONS: Sufferers assembly inclusion standards acquired fluoroscope-guided BTESI of native anesthetic and steroid on the degree instantly under essentially the most stenotic degree. Affected person self-reported ache degree, exercise degree, and total satisfaction had been recorded by phone interview at 1, three, and 6 months after injection by an unbiased observer.
MAIN OUTCOME MEASURES: Ache rating and Swiss Spinal Stenosis rating at baseline, 1, three, and 6 months.
RESULTS: Of the 22 contributors eligible for evaluation, 20, 19, and 18 had follow-up information obtainable at 1, three, and 6 months, respectively. Discount in numeric ache scale rating of at the least 50% was famous in 30% of contributors at 1 month, 53% at three months, and 44% at 6 months. Swiss Spinal Stenosis subscale scores indicated a major discount within the proportion of contributors reporting the presence of extreme ache within the again, buttocks, and legs (significantly the again or buttocks) at 1, three, and 6 months of follow-up in contrast with baseline (P < .05). The proportion of contributors reporting extreme weak point within the legs or toes additionally decreased after injection and was statistically important at three months of follow-up (P = .04).
CONCLUSIONS: Fluoroscope-guided BTESI was reasonably efficient in lowering ache, bettering perform, and attaining affected person satisfaction in sufferers with NC from DLSS on the central spinal canal on this medical case collection.
LEVEL OF EVIDENCE: IV.

PMID: 27292437 [PubMed – indexed for MEDLINE]

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2022-06-10
Fabulous service Fabulous service. Mr Akmal truly cares about his patients and how he can improve their quality of life. I would recommend him to anyone with any kind of spinal issue.
Honeywell Paul
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2022-06-08
Truly excellent results! I was diagnosed with lumbar stenosis after experiencing increasing pain in both legs. An MRI and consultation carried out at short notice confirmed this. Mr Akmal recommended that a spacer should be inserted in my lower back to correct the problem and release the nerves from the narrowing caused by stenosis. The operation was conducted very professionally and without pain. After the first two weeks the pain started to subside as expected. After 4 weeks I was completely back to normal. The result is exceptionally good and I feel renewed, with no pain whatsoever and a regained posture, ready to resume a normal life. I cannot recommend The London Spine Unit highly enough. They are medical magicians!
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2022-06-06
Sciatica My mother was in absolute agony for more than 3 months due to sciatica. It just came out of nowhere and took her out of action. From working full time she went straight to being bed bound and unable to carry out simplest of actions.The pain was 9/10 and she was bed bound for those three months. Multiple trips to A&E and GP and they wouldn't class it as an emergency therefore they wouldn't do anything about it other than upgrading the painkillers which did next to nothing for my mother. I couldn't bear to watch my mother sleeping on A&E bench in pain for 7 hours, just to be told by doctors that she wouldn't be kept in. I remember her joining her hands and begging the doctors to stop the pain which broke my heart. I then started doing research on google and London spine unit came up with Dr Mo AKMAL's profile and review. First meeting with Dr AKMAL was via ZOOM as my mother was bed bound. Dr AKMAL spoke to me and my mom and told us that this is nothing to worry about and that the pain would be 100% gone.Dr AKMAL assured us to visit the hospital so he could physically inspect my mother and give us the best solution. One trip to the london spine unit and Dr AKMAL advised us that the best solution would be to carry out Minimally invasive disectomy. Dr AKMAL advised that due to my mother being bed bound for a while, steroid injection might not give the result that my mother wishes. Dr AKMAL was very confident and showed us some videos from other patients who had gone through the same ordeal. The biggest thing i noticed between before and after was the smile on the patients face. Dr AKMAL was constantly assuring my mother throughout the meeting that he would take care of her pain and gave her 100% confidence that the result would be delivered.He promised her that she would be walking pain free the same day after the operation. Before the operation Dr GURUNG was consulted multiple times and he also was very helpful. Right after the surgery, as Dr AKMAL promised, my mother was walking and the biggest thing was that the pain was gone. My mother had forgotten to smile for three months and there i saw her smiling again. Dr AKMAL and Dr GURUNG gave us brilliant aftercare and informed us that just give them a ring if there was any issue. Its been several weeks now and my mother is heading towards complete recovery without any issues. The pain is completely gone and anyone who is reading this going through the same horrible sciatica pain you must come and see Dr AKMAL. Thank you Dr AKMAL and your whole team for helping my mom achieve this pain free life.
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2022-05-18
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2022-05-18
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2022-05-09
Excellent treatment Mr Mo Akmal treated me very successfully for 2 torn discs in my back. I was in tremendous pain before I was referred to him. The treatment I received from him was excellent and he communicated with me very well throughout the whole process. I am eternally grateful to Mr Akmal for sorting out my back and would highly recommend him.
shahnaz Choudhury
shahnaz Choudhury
2022-04-22
I had a massive bulging disk on my back… I had a massive bulging disk on my back compressing my nerve for three years. It caused me excruciating pain and almost left me disabled. I was on both crutches and completely homebound due to the severity of pain and mobility limitations. I had my lumber surgery two weeks ago and walked out of hospital within a few hours pain free on my right leg that was almost paralysing prior to surgery. The disk was shaved off releasing the nerve completely. Two days after surgery I had excruciating pain on my head that is unexplained as I had CT scan and MRI which were all fine. Dr Akmal has suggested it could be from the anaesthetic. I am extremely grateful to Dr Akmal and his very welcoming and cari g team. I would highly recommend his clinic as I have had excellent recovery.
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2022-04-02
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Ken Carswell
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2022-03-22
Amazing service and an amazing treatment! I can't thank Mr Akmal and team at the London Spine Unit enough for their help. I had a herniated disc in my back which was causing pain and restrictions. Compared to other offers of surgery (e.g. several nights in hospital), the day surgery and minimally invasive procedure were hugely appealing. I am now 3 weeks post surgery, have no pain and am recovering incredibly quickly if I compare myself to friends who have had a similar procedure. it was truly remarkable, straightforward and the team were kind, friendly and always helpful. very highly recommended!
customer
customer
2022-03-17
Great service and painless procedure Great service and painless procedure. Definitely alleviated the pain

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