Evaluation of epidural blockade as therapy for patients with sciatica secondary to lumbar disc herniation

Detalhes bibliográficos
Autor(a) principal: Nunes,Rogerio Carlos Sanfelice
Data de Publicação: 2016
Outros Autores: Pontes,Elenir Rose Jardim Cury, Costa,Izaias Pereira da
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Revista Brasileira de Ortopedia (Online)
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-36162016000400424
Resumo: ABSTRACT OBJECTIVE: Sciatic pain secondary to lumbar disc herniation is a complex condition that is often highly limiting. The causes of pain in disc herniation are multifactorial. Two physiopathological mechanisms are involved in discogenic pain: mechanical deformation of nerve roots and a biochemical inflammatory component resulting from contact between the intervertebral disc and neural tissue, by way of the nucleus pulposus. The aim of this study was to evaluate the efficacy and safety of epidural blockade as therapy for bulging lumbar disc herniation. METHODS: A clinical study was conducted based on a retrospective and prospective survey. The blockade consisted of interlaminar puncture and bolus drug delivery. The number of procedures varied according to the clinical response, as determined through weekly evaluations and then 30, 90, and 180 days after the final session. A total of 124 patients who received one to five blockades were evaluated. RESULTS: The success rate (defining success as a reduction in sciatic pain of at least 80%) was 75.8%. CONCLUSION: The results demonstrated the therapeutic action of epidural blockade over the short term, i.e. in cases of acute pain, thus showing that intense and excruciating sciatic pain can be relieved through this technique. Because of the multifactorial genesis of sciatica and the difficulties encountered by healthcare professionals in treating this condition, epidural blockade can become part of therapeutic arsenal available. This procedure is situated between conservative treatment with an eminently clinical focus and surgical approaches.
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spelling Evaluation of epidural blockade as therapy for patients with sciatica secondary to lumbar disc herniationIntervertebral disc displacementLumbar painNerve blockABSTRACT OBJECTIVE: Sciatic pain secondary to lumbar disc herniation is a complex condition that is often highly limiting. The causes of pain in disc herniation are multifactorial. Two physiopathological mechanisms are involved in discogenic pain: mechanical deformation of nerve roots and a biochemical inflammatory component resulting from contact between the intervertebral disc and neural tissue, by way of the nucleus pulposus. The aim of this study was to evaluate the efficacy and safety of epidural blockade as therapy for bulging lumbar disc herniation. METHODS: A clinical study was conducted based on a retrospective and prospective survey. The blockade consisted of interlaminar puncture and bolus drug delivery. The number of procedures varied according to the clinical response, as determined through weekly evaluations and then 30, 90, and 180 days after the final session. A total of 124 patients who received one to five blockades were evaluated. RESULTS: The success rate (defining success as a reduction in sciatic pain of at least 80%) was 75.8%. CONCLUSION: The results demonstrated the therapeutic action of epidural blockade over the short term, i.e. in cases of acute pain, thus showing that intense and excruciating sciatic pain can be relieved through this technique. Because of the multifactorial genesis of sciatica and the difficulties encountered by healthcare professionals in treating this condition, epidural blockade can become part of therapeutic arsenal available. This procedure is situated between conservative treatment with an eminently clinical focus and surgical approaches.Sociedade Brasileira de Ortopedia e Traumatologia2016-08-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-36162016000400424Revista Brasileira de Ortopedia v.51 n.4 2016reponame:Revista Brasileira de Ortopedia (Online)instname:Sociedade Brasileira de Ortopedia e Traumatologia (SBOT)instacron:SBOT10.1016/j.rboe.2015.09.014info:eu-repo/semantics/openAccessNunes,Rogerio Carlos SanfelicePontes,Elenir Rose Jardim CuryCosta,Izaias Pereira daeng2016-08-23T00:00:00Zoai:scielo:S0102-36162016000400424Revistahttp://www.rbo.org.br/https://old.scielo.br/oai/scielo-oai.php||rbo@sbot.org.br1982-43780102-3616opendoar:2016-08-23T00:00Revista Brasileira de Ortopedia (Online) - Sociedade Brasileira de Ortopedia e Traumatologia (SBOT)false
dc.title.none.fl_str_mv Evaluation of epidural blockade as therapy for patients with sciatica secondary to lumbar disc herniation
title Evaluation of epidural blockade as therapy for patients with sciatica secondary to lumbar disc herniation
spellingShingle Evaluation of epidural blockade as therapy for patients with sciatica secondary to lumbar disc herniation
Nunes,Rogerio Carlos Sanfelice
Intervertebral disc displacement
Lumbar pain
Nerve block
title_short Evaluation of epidural blockade as therapy for patients with sciatica secondary to lumbar disc herniation
title_full Evaluation of epidural blockade as therapy for patients with sciatica secondary to lumbar disc herniation
title_fullStr Evaluation of epidural blockade as therapy for patients with sciatica secondary to lumbar disc herniation
title_full_unstemmed Evaluation of epidural blockade as therapy for patients with sciatica secondary to lumbar disc herniation
title_sort Evaluation of epidural blockade as therapy for patients with sciatica secondary to lumbar disc herniation
author Nunes,Rogerio Carlos Sanfelice
author_facet Nunes,Rogerio Carlos Sanfelice
Pontes,Elenir Rose Jardim Cury
Costa,Izaias Pereira da
author_role author
author2 Pontes,Elenir Rose Jardim Cury
Costa,Izaias Pereira da
author2_role author
author
dc.contributor.author.fl_str_mv Nunes,Rogerio Carlos Sanfelice
Pontes,Elenir Rose Jardim Cury
Costa,Izaias Pereira da
dc.subject.por.fl_str_mv Intervertebral disc displacement
Lumbar pain
Nerve block
topic Intervertebral disc displacement
Lumbar pain
Nerve block
description ABSTRACT OBJECTIVE: Sciatic pain secondary to lumbar disc herniation is a complex condition that is often highly limiting. The causes of pain in disc herniation are multifactorial. Two physiopathological mechanisms are involved in discogenic pain: mechanical deformation of nerve roots and a biochemical inflammatory component resulting from contact between the intervertebral disc and neural tissue, by way of the nucleus pulposus. The aim of this study was to evaluate the efficacy and safety of epidural blockade as therapy for bulging lumbar disc herniation. METHODS: A clinical study was conducted based on a retrospective and prospective survey. The blockade consisted of interlaminar puncture and bolus drug delivery. The number of procedures varied according to the clinical response, as determined through weekly evaluations and then 30, 90, and 180 days after the final session. A total of 124 patients who received one to five blockades were evaluated. RESULTS: The success rate (defining success as a reduction in sciatic pain of at least 80%) was 75.8%. CONCLUSION: The results demonstrated the therapeutic action of epidural blockade over the short term, i.e. in cases of acute pain, thus showing that intense and excruciating sciatic pain can be relieved through this technique. Because of the multifactorial genesis of sciatica and the difficulties encountered by healthcare professionals in treating this condition, epidural blockade can become part of therapeutic arsenal available. This procedure is situated between conservative treatment with an eminently clinical focus and surgical approaches.
publishDate 2016
dc.date.none.fl_str_mv 2016-08-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
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dc.identifier.uri.fl_str_mv http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-36162016000400424
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-36162016000400424
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 10.1016/j.rboe.2015.09.014
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dc.format.none.fl_str_mv text/html
dc.publisher.none.fl_str_mv Sociedade Brasileira de Ortopedia e Traumatologia
publisher.none.fl_str_mv Sociedade Brasileira de Ortopedia e Traumatologia
dc.source.none.fl_str_mv Revista Brasileira de Ortopedia v.51 n.4 2016
reponame:Revista Brasileira de Ortopedia (Online)
instname:Sociedade Brasileira de Ortopedia e Traumatologia (SBOT)
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reponame_str Revista Brasileira de Ortopedia (Online)
collection Revista Brasileira de Ortopedia (Online)
repository.name.fl_str_mv Revista Brasileira de Ortopedia (Online) - Sociedade Brasileira de Ortopedia e Traumatologia (SBOT)
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