Clinical and imaging characteristics of patients with extreme low back pain or sciatica referred for spinal injection
Purpose To analyze the causes of pain, imaging characteristics, and therapeutic effect of spinal injection in patients with extreme low back pain or sciatica. Methods We analyzed 381 consecutive patients with extreme low back pain or sciatica visiting our spinal intervention center between January a...
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| Veröffentlicht in: | Neuroradiology 2019-08, Vol.61 (8), p.881-889 |
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| creator | Kim, Youngjune Lee, Eugene Lee, Joon Woo Kang, Yusuhn Ahn, Joong Mo Kang, Heung Sik |
| description | Purpose
To analyze the causes of pain, imaging characteristics, and therapeutic effect of spinal injection in patients with extreme low back pain or sciatica.
Methods
We analyzed 381 consecutive patients with extreme low back pain or sciatica visiting our spinal intervention center between January and December 2017. Clinical and imaging characteristics were analyzed. The treatment response, defined as a numerical pain rating scale decrease of ≥ 30%, was measured. Fisher’s exact test was performed to identify the association between the injection response and subsequent lumbar surgery rate.
Results
The most frequent cause of pain was spinal stenosis, followed by herniated intervertebral disc, facet osteoarthritis, and osteoporotic compression fracture. A herniated intervertebral disc was the most common disorder in patients |
| doi_str_mv | 10.1007/s00234-019-02222-z |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2232042957</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2232042957</sourcerecordid><originalsourceid>FETCH-LOGICAL-c423t-f1958ea5f498e3ca5263a6db741afd231b5ff0be53993041dd4eb3dc56c0bdd03</originalsourceid><addsrcrecordid>eNp9kU9PGzEQxa2qqKS0X6CHylIvXBbGf3Y3PqIIKBJSL-3Z8trj4HTjDbZXtHx6HEKL1EN9seT3ezPjeYR8YnDGAPrzDMCFbICpBng9zeMbsmBS8IYpDm_JourLRigJx-R9zhsAEL3o35FjwVh1yX5B5tUYYrBmpCY6GrZmHeKa2juTjC2YQi7BZjp5ujMlYCyZPoRyR_FXSbhFOk4PdDD2Z5VDpFOi2YYKWkMTekwJHfX7112ItUWIG7QlTPEDOfJmzPjx5T4hP64uv6--Nrffrm9WF7eNlVyUxjPVLtG0XqolCmta3gnTuaGXzHjHBRta72HAViglQDLnJA7C2bazMDgH4oScHuru0nQ_Yy56G7LFcTQRpzlrzgUHyVXbV_TLP-hmmlOdek_xruNLAapS_EDZNOVc_6h3qS4t_dYM9D4UfQhF1_Xq51D0YzV9fik9D1t0fy1_UqiAOAC5SnGN6bX3f8o-AUXBmXI</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2226628309</pqid></control><display><type>article</type><title>Clinical and imaging characteristics of patients with extreme low back pain or sciatica referred for spinal injection</title><source>MEDLINE</source><source>SpringerNature Journals</source><creator>Kim, Youngjune ; Lee, Eugene ; Lee, Joon Woo ; Kang, Yusuhn ; Ahn, Joong Mo ; Kang, Heung Sik</creator><creatorcontrib>Kim, Youngjune ; Lee, Eugene ; Lee, Joon Woo ; Kang, Yusuhn ; Ahn, Joong Mo ; Kang, Heung Sik</creatorcontrib><description>Purpose
To analyze the causes of pain, imaging characteristics, and therapeutic effect of spinal injection in patients with extreme low back pain or sciatica.
Methods
We analyzed 381 consecutive patients with extreme low back pain or sciatica visiting our spinal intervention center between January and December 2017. Clinical and imaging characteristics were analyzed. The treatment response, defined as a numerical pain rating scale decrease of ≥ 30%, was measured. Fisher’s exact test was performed to identify the association between the injection response and subsequent lumbar surgery rate.
Results
The most frequent cause of pain was spinal stenosis, followed by herniated intervertebral disc, facet osteoarthritis, and osteoporotic compression fracture. A herniated intervertebral disc was the most common disorder in patients < 50 years of age, while spinal stenosis was the most common in patients ≥ 50 years of age. Women comprised 66.4% of the study population. The majority of lumbar pathologies occurred below L3/4. Spinal injection was found to be effective in 44.2% of cases. Those who responded to the injection showed a significantly lower rate of lumbar surgery within 6 months (
P
= 0.004).
Conclusions
Those with extreme low back pain or sciatica had clinical and imaging characteristics similar to those with typical low back pain referred for spinal injection. Spinal injection could be an effective method of pain control for patients with extreme low back pain or sciatica.</description><identifier>ISSN: 0028-3940</identifier><identifier>EISSN: 1432-1920</identifier><identifier>DOI: 10.1007/s00234-019-02222-z</identifier><identifier>PMID: 31101947</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adult ; Aged ; Anesthetics, Local - administration & dosage ; Back pain ; Biocompatibility ; Biomedical materials ; Chiropractic medicine ; Compression ; Dexamethasone - administration & dosage ; Female ; Glucocorticoids - administration & dosage ; Humans ; Imaging ; Injection ; Injections, Spinal ; Intervertebral discs ; Low back pain ; Low Back Pain - diagnostic imaging ; Low Back Pain - drug therapy ; Low Back Pain - etiology ; Lumbar Vertebrae ; Magnetic Resonance Imaging ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Neurology ; Neuroradiology ; Neurosciences ; Neurosurgery ; Osteoarthritis ; Osteoporosis ; Pain ; Pain Measurement ; Patients ; Population studies ; Radiology ; Retrospective Studies ; Ropivacaine - administration & dosage ; Sciatica ; Sciatica - diagnostic imaging ; Sciatica - drug therapy ; Sciatica - etiology ; Spinal Diseases - complications ; Spinal Diseases - diagnostic imaging ; Spinal Neuroradiology ; Spinal stenosis ; Surgery</subject><ispartof>Neuroradiology, 2019-08, Vol.61 (8), p.881-889</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2019</rights><rights>Neuroradiology is a copyright of Springer, (2019). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c423t-f1958ea5f498e3ca5263a6db741afd231b5ff0be53993041dd4eb3dc56c0bdd03</citedby><cites>FETCH-LOGICAL-c423t-f1958ea5f498e3ca5263a6db741afd231b5ff0be53993041dd4eb3dc56c0bdd03</cites><orcidid>0000-0003-4205-2362</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00234-019-02222-z$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00234-019-02222-z$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31101947$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kim, Youngjune</creatorcontrib><creatorcontrib>Lee, Eugene</creatorcontrib><creatorcontrib>Lee, Joon Woo</creatorcontrib><creatorcontrib>Kang, Yusuhn</creatorcontrib><creatorcontrib>Ahn, Joong Mo</creatorcontrib><creatorcontrib>Kang, Heung Sik</creatorcontrib><title>Clinical and imaging characteristics of patients with extreme low back pain or sciatica referred for spinal injection</title><title>Neuroradiology</title><addtitle>Neuroradiology</addtitle><addtitle>Neuroradiology</addtitle><description>Purpose
To analyze the causes of pain, imaging characteristics, and therapeutic effect of spinal injection in patients with extreme low back pain or sciatica.
Methods
We analyzed 381 consecutive patients with extreme low back pain or sciatica visiting our spinal intervention center between January and December 2017. Clinical and imaging characteristics were analyzed. The treatment response, defined as a numerical pain rating scale decrease of ≥ 30%, was measured. Fisher’s exact test was performed to identify the association between the injection response and subsequent lumbar surgery rate.
Results
The most frequent cause of pain was spinal stenosis, followed by herniated intervertebral disc, facet osteoarthritis, and osteoporotic compression fracture. A herniated intervertebral disc was the most common disorder in patients < 50 years of age, while spinal stenosis was the most common in patients ≥ 50 years of age. Women comprised 66.4% of the study population. The majority of lumbar pathologies occurred below L3/4. Spinal injection was found to be effective in 44.2% of cases. Those who responded to the injection showed a significantly lower rate of lumbar surgery within 6 months (
P
= 0.004).
Conclusions
Those with extreme low back pain or sciatica had clinical and imaging characteristics similar to those with typical low back pain referred for spinal injection. Spinal injection could be an effective method of pain control for patients with extreme low back pain or sciatica.</description><subject>Adult</subject><subject>Aged</subject><subject>Anesthetics, Local - administration & dosage</subject><subject>Back pain</subject><subject>Biocompatibility</subject><subject>Biomedical materials</subject><subject>Chiropractic medicine</subject><subject>Compression</subject><subject>Dexamethasone - administration & dosage</subject><subject>Female</subject><subject>Glucocorticoids - administration & dosage</subject><subject>Humans</subject><subject>Imaging</subject><subject>Injection</subject><subject>Injections, Spinal</subject><subject>Intervertebral discs</subject><subject>Low back pain</subject><subject>Low Back Pain - diagnostic imaging</subject><subject>Low Back Pain - drug therapy</subject><subject>Low Back Pain - etiology</subject><subject>Lumbar Vertebrae</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Neurology</subject><subject>Neuroradiology</subject><subject>Neurosciences</subject><subject>Neurosurgery</subject><subject>Osteoarthritis</subject><subject>Osteoporosis</subject><subject>Pain</subject><subject>Pain Measurement</subject><subject>Patients</subject><subject>Population studies</subject><subject>Radiology</subject><subject>Retrospective Studies</subject><subject>Ropivacaine - administration & dosage</subject><subject>Sciatica</subject><subject>Sciatica - diagnostic imaging</subject><subject>Sciatica - drug therapy</subject><subject>Sciatica - etiology</subject><subject>Spinal Diseases - complications</subject><subject>Spinal Diseases - diagnostic imaging</subject><subject>Spinal Neuroradiology</subject><subject>Spinal stenosis</subject><subject>Surgery</subject><issn>0028-3940</issn><issn>1432-1920</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kU9PGzEQxa2qqKS0X6CHylIvXBbGf3Y3PqIIKBJSL-3Z8trj4HTjDbZXtHx6HEKL1EN9seT3ezPjeYR8YnDGAPrzDMCFbICpBng9zeMbsmBS8IYpDm_JourLRigJx-R9zhsAEL3o35FjwVh1yX5B5tUYYrBmpCY6GrZmHeKa2juTjC2YQi7BZjp5ujMlYCyZPoRyR_FXSbhFOk4PdDD2Z5VDpFOi2YYKWkMTekwJHfX7112ItUWIG7QlTPEDOfJmzPjx5T4hP64uv6--Nrffrm9WF7eNlVyUxjPVLtG0XqolCmta3gnTuaGXzHjHBRta72HAViglQDLnJA7C2bazMDgH4oScHuru0nQ_Yy56G7LFcTQRpzlrzgUHyVXbV_TLP-hmmlOdek_xruNLAapS_EDZNOVc_6h3qS4t_dYM9D4UfQhF1_Xq51D0YzV9fik9D1t0fy1_UqiAOAC5SnGN6bX3f8o-AUXBmXI</recordid><startdate>20190801</startdate><enddate>20190801</enddate><creator>Kim, Youngjune</creator><creator>Lee, Eugene</creator><creator>Lee, Joon Woo</creator><creator>Kang, Yusuhn</creator><creator>Ahn, Joong Mo</creator><creator>Kang, Heung Sik</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7TK</scope><scope>7U7</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>M7P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-4205-2362</orcidid></search><sort><creationdate>20190801</creationdate><title>Clinical and imaging characteristics of patients with extreme low back pain or sciatica referred for spinal injection</title><author>Kim, Youngjune ; Lee, Eugene ; Lee, Joon Woo ; Kang, Yusuhn ; Ahn, Joong Mo ; Kang, Heung Sik</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c423t-f1958ea5f498e3ca5263a6db741afd231b5ff0be53993041dd4eb3dc56c0bdd03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Anesthetics, Local - administration & dosage</topic><topic>Back pain</topic><topic>Biocompatibility</topic><topic>Biomedical materials</topic><topic>Chiropractic medicine</topic><topic>Compression</topic><topic>Dexamethasone - administration & dosage</topic><topic>Female</topic><topic>Glucocorticoids - administration & dosage</topic><topic>Humans</topic><topic>Imaging</topic><topic>Injection</topic><topic>Injections, Spinal</topic><topic>Intervertebral discs</topic><topic>Low back pain</topic><topic>Low Back Pain - diagnostic imaging</topic><topic>Low Back Pain - drug therapy</topic><topic>Low Back Pain - etiology</topic><topic>Lumbar Vertebrae</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Neurology</topic><topic>Neuroradiology</topic><topic>Neurosciences</topic><topic>Neurosurgery</topic><topic>Osteoarthritis</topic><topic>Osteoporosis</topic><topic>Pain</topic><topic>Pain Measurement</topic><topic>Patients</topic><topic>Population studies</topic><topic>Radiology</topic><topic>Retrospective Studies</topic><topic>Ropivacaine - administration & dosage</topic><topic>Sciatica</topic><topic>Sciatica - diagnostic imaging</topic><topic>Sciatica - drug therapy</topic><topic>Sciatica - etiology</topic><topic>Spinal Diseases - complications</topic><topic>Spinal Diseases - diagnostic imaging</topic><topic>Spinal Neuroradiology</topic><topic>Spinal stenosis</topic><topic>Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kim, Youngjune</creatorcontrib><creatorcontrib>Lee, Eugene</creatorcontrib><creatorcontrib>Lee, Joon Woo</creatorcontrib><creatorcontrib>Kang, Yusuhn</creatorcontrib><creatorcontrib>Ahn, Joong Mo</creatorcontrib><creatorcontrib>Kang, Heung Sik</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Neurosciences Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Biological Science Database</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Neuroradiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kim, Youngjune</au><au>Lee, Eugene</au><au>Lee, Joon Woo</au><au>Kang, Yusuhn</au><au>Ahn, Joong Mo</au><au>Kang, Heung Sik</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical and imaging characteristics of patients with extreme low back pain or sciatica referred for spinal injection</atitle><jtitle>Neuroradiology</jtitle><stitle>Neuroradiology</stitle><addtitle>Neuroradiology</addtitle><date>2019-08-01</date><risdate>2019</risdate><volume>61</volume><issue>8</issue><spage>881</spage><epage>889</epage><pages>881-889</pages><issn>0028-3940</issn><eissn>1432-1920</eissn><abstract>Purpose
To analyze the causes of pain, imaging characteristics, and therapeutic effect of spinal injection in patients with extreme low back pain or sciatica.
Methods
We analyzed 381 consecutive patients with extreme low back pain or sciatica visiting our spinal intervention center between January and December 2017. Clinical and imaging characteristics were analyzed. The treatment response, defined as a numerical pain rating scale decrease of ≥ 30%, was measured. Fisher’s exact test was performed to identify the association between the injection response and subsequent lumbar surgery rate.
Results
The most frequent cause of pain was spinal stenosis, followed by herniated intervertebral disc, facet osteoarthritis, and osteoporotic compression fracture. A herniated intervertebral disc was the most common disorder in patients < 50 years of age, while spinal stenosis was the most common in patients ≥ 50 years of age. Women comprised 66.4% of the study population. The majority of lumbar pathologies occurred below L3/4. Spinal injection was found to be effective in 44.2% of cases. Those who responded to the injection showed a significantly lower rate of lumbar surgery within 6 months (
P
= 0.004).
Conclusions
Those with extreme low back pain or sciatica had clinical and imaging characteristics similar to those with typical low back pain referred for spinal injection. Spinal injection could be an effective method of pain control for patients with extreme low back pain or sciatica.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>31101947</pmid><doi>10.1007/s00234-019-02222-z</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0003-4205-2362</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0028-3940 |
| ispartof | Neuroradiology, 2019-08, Vol.61 (8), p.881-889 |
| issn | 0028-3940 1432-1920 |
| language | eng |
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| source | MEDLINE; SpringerNature Journals |
| subjects | Adult Aged Anesthetics, Local - administration & dosage Back pain Biocompatibility Biomedical materials Chiropractic medicine Compression Dexamethasone - administration & dosage Female Glucocorticoids - administration & dosage Humans Imaging Injection Injections, Spinal Intervertebral discs Low back pain Low Back Pain - diagnostic imaging Low Back Pain - drug therapy Low Back Pain - etiology Lumbar Vertebrae Magnetic Resonance Imaging Male Medicine Medicine & Public Health Middle Aged Neurology Neuroradiology Neurosciences Neurosurgery Osteoarthritis Osteoporosis Pain Pain Measurement Patients Population studies Radiology Retrospective Studies Ropivacaine - administration & dosage Sciatica Sciatica - diagnostic imaging Sciatica - drug therapy Sciatica - etiology Spinal Diseases - complications Spinal Diseases - diagnostic imaging Spinal Neuroradiology Spinal stenosis Surgery |
| title | Clinical and imaging characteristics of patients with extreme low back pain or sciatica referred for spinal injection |
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