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Study: Triamcinolone and dexamethasone effective for acute radicular pain

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ORLANDO, Fla. — The effectiveness of lumbar transforaminal epidural steroid injections with particulate or nonparticulate corticosteroids for the management of lumbar radicular pain was found to be similar in study findings presented at the International Spine Intervention Society Annual Meeting, here.

However, there were some key differences in the treatment methods, according to D.J. Kennedy, MD, who presented the results of the prospective, randomized, double-blind trial.

“Dexamethasone and triamcinolone result in equal outcomes at the cost of slight increase in number of subjects undergoing three injections,” Kennedy said.

D.J. Kennedy

The study Kennedy and colleagues conducted included 78 patients with pain due to one-level intervertebral disc herniation and were divided into two treatment groups. Forty patients received a 60 mg injection of triamcinolone and 38 patients received a 15 mg injection of dexamethasone.

Kennedy said in his presentation the outcomes in both groups were similar for pain reduction at 2 weeks and 6 months follow-up.

At 2 weeks a 50% pain reduction was reported by 32.7% of the dexamethasone group and 44.6% of the triamcinolone group. At 6 months, an 80% pain reduction was reported by 82.8% of the dexamethasone group and 80.4% of the triamcinolone group, according to the study abstract.

However, Kennedy said about 17% of patients in the dexamethasone group had to have three injections to achieve the results compared to 2.7% of the patients in the triamcinolone group who received three injections. – by Robert Linnehan

References:

Kennedy DJ. Comparative effectiveness of lumbar transforaminal epidural steroid injections with particulate vs. nonparticulate corticosteroids for lumbar radicular pain due to intervertebral disc herniation: A prospective, randomized double-blind trial. Presented at: International Spine Intervention Society Annual Meeting; July 30-Aug. 3, 2014; Orlando, Fla.

Kennedy DJ. Pain Med. 2014;doi:10.1111/pme.12321. Epub 2014 Jan 2.

Disclosure: Kennedy has no relevant financial disclosures.