Menu
Menu
19 Harley St, London, W1G 9QJ, UK

Targeted methylprednisolone acetate/hyaluronidase/clonidine injection after diagnostic epiduroscopy for chronic sciatica: a prospective, 1-year follow-up study

BACKGROUND AND OBJECTIVES: It has been claimed that epiduroscopy offers an ideal combination of diagnostic and therapeutic interventions in one session. We prospectively evaluated whether abnormalities at the lumbar level as diagnosed by magnetic resonance imaging (MRI) are confirmed by epiduroscopy, and assessed if targeted epidural injection of medication alleviates sciatic pain. METHODS: A flexible, 0.9-mm fiberoptic endoscope was introduced through a disposable steering shaft into the caudal epidural space and advanced until the targeted spinal nerve was identified. Adhesions were mechanically mobilized under direct vision, and a mixture of 120 mg methylprednisolone acetate, 600 IU hyaluronidase, and 150 microg clonidine was applied locally. Pain scores were measured by visual analog scale (VAS) and global subjective efficacy rating. RESULTS: Nineteen of 20 patients studied showed adhesions via epiduroscopy. In 8 patients, 6 of whom had never undergone surgery, these were not detected with earlier magnetic resonance imaging. Six patients showed concomitant signs of active root inflammation. Of 20 patients treated with a targeted epidural injection, 11 patients (55%) experienced significant pain relief at 3 months. This was maintained at 6, 9, and 12 months for 8 (40%), 7 (35%), and 7 (35%) patients, respectively. Mean VAS at 3 months was significantly reduced (n = 20; DeltaVAS = 3.55; P <.0001), and this persisted at 12 months (DeltaVAS = 1.99, P =.0073). CONCLUSIONS: Epiduroscopy is of value in the diagnosis of spinal root pathology. In sciatica, adhesions unreported by MRI can be identified. Targeted epidural medication, administered near the compromised spinal nerve, results in substantial and prolonged pain relief Keywords : abnormalities,administration & dosage,Adult,Aged,analogs & derivatives,Anesthesiology,Chronic Disease,Clonidine,diagnosis,drug therapy,Drug Therapy,Combination,Endoscopy,Epidural Space,Female,Follow-Up Studies,Humans,Hyaluronoglucosaminidase,Inflammation,Injections,Magnetic Resonance Imaging,Male,methods,Methylprednisolone,Methylprednisolone Acetate,Middle Aged,Netherlands,Pain,Pain Measurement,pathology,Patients,Prospective Studies,Sciatica,surgery,, Methylprednisolone,Acetate/Hyaluronidase/Clonidine,Injection,After,Diagnostic, diaphragm breathing vs chest breathing

Date of Publication : 2002 Jul

Authors : Geurts JW;Kallewaard JW;Richardson J;Groen GJ;

Organisation : Department of Anesthesiology, Rijnstate Hospital, Arnhem, The Netherlands. anesthesiologen.arnhem@planet.nl

Journal of Publication : Reg Anesth Pain Med

Pubmed Link : https://www.ncbi.nlm.nih.gov/pubmed/12132057

The London Spine Unit : Harley Street UK. Specialists in Cutting Edge Technologies for Spinal Surgery

Make an Appointment 

Trustpilot Reviews
Doctify Reviews
Top Doctor Reviews

Targeted methylprednisolone acetate/hyaluronidase/clonidine injection after diagnostic epiduroscopy for chronic sciatica a prospective, 1-year follow-up study | Nerve specialist uk

What our patients say ...

Consultant Spinal Surgeon
Consultant Spinal Surgeon
Consultant Spinal Surgeon
Consultant Spinal Surgeon
Consultant Spinal Surgeon
Consultant Spinal Anaesthetist

This surgical technique consists of a percutaneous approach for the treatment of small to medium size hernias of the intervertebral disc by laser energy. The main objective is to reduce the intradiscal pressure in the nucleus pulposus

Laser Disc Surgery can be performed under local anaesthetic as a day case at our centre on the prestigious Harley Street.
What is London spine unit and How it Works

The London Spine Unit was established in 2005 and has successfully treated over 5000 patients. All conditions are treated.

treatment of all spinal disorders

The London Spine Unit specialises in Minimally Invasive Treatments allowing rapid recovery and return to normal function

Trusted by patients worldwide

The London Spine Unit provides the highest quality care to all patients and has VIP services for those seeking exceptional services

If you have any emergency Doctor’s need, simply call our 24 hour emergency

Your personal case manager will ensure that you receive the best possible care.

Call Now 

+44 844 589 2020
+44 203 973 8810