Epidural Corticosteroid Injections for Sciatica Due to Herniated Nucleus Pulposus

Sciatica due to a herniated nucleus pulposus is an important medical and socioeconomic problem. 1 Although the majority of patients recover with conservative management, 10 to 15 percent need surgery. 2 Epidural corticosteroid injections were first used to treat sciatica in the early 1950s, as reported by Lièvre et al. 3 , 4 Of 12 controlled trials that have subsequently been reported, half found that the injections were more effective than the reference treatment, 5 – 10 and the other half found them to be no better or worse. 11 – 16 A critical analysis of these studies showed that most had methodologic deficiencies. 17 Reviews of the literature . . .