Skip to main content
European Spine Journal logoLink to European Spine Journal
. 1997 Sep;6(5):357–361. doi: 10.1007/BF01142687

Lumbar epidural perineural injection: a new technique

J Kraemer 1,, J Ludwig 1, U Bickert 1, V Owczarek 1, M Traupe 2
PMCID: PMC3454603  PMID: 9391811

Abstract

Two controlled studies for a new epidural, perineural, singleshot, selective nerve root injection with a double-needle approach to the anterior epidural space of the lumbar spinal canal are presented. The results were analysed to determine the effectiveness of the new epidural perineural injection technique. The trial comprised two controlled studies on 182 patients. One study compared prospectively randomized results of patients with lumbar radicular syndromes who received epidural perineural injections (n = 47), conventional posterior epidural injections (n = 40) and, as a control group, paravertebral local anaesthetic (n = 46). A second, prospective, double-blind study compared the effect of epidural perineural injections with triamcinolone (n = 24) and pure saline (n = 25). Epidural perineural injections were more effective than conventional posterior epidural injections. Both epidural groups had better results than the paravertebral local injection group. Epidural perineural injections with steroids (10 mg triamcinolone) were more effective than saline alone. A systemic steroid effect was excluded by additional intramuscular steroid injections in the saline group. There were no severe complications or side effects in any of the three groups. The studies concluded that single-shot epidural perineural injection is effective in the treatment of lumbar radicular pain. It is a “one drop only” therapy to the source of pain.

Key words: Epidural perineural injection, Local injection therapy, Lumbar radicular syndrome, Conservative treatment

Full Text

The Full Text of this article is available as a PDF (1.0 MB).

References

  • 1.Barry PJC, Hume-Kendall P. Corticosteroid infiltration of the epidural space. Ann Phys Med. 1982;6:267–273. doi: 10.1093/rheumatology/6.6.267. [DOI] [PubMed] [Google Scholar]
  • 2.Bernau A. The effects of epidural injections. Clin Ortho. 1984;188:144. [Google Scholar]
  • 3.Bhatia MT, Parikh LCJ. Epidural saline therapy in lumbo-sciatic syndrome. J Indian Med Assoc. 1966;47:537–542. [PubMed] [Google Scholar]
  • 4.Bianchi GGS, Jeanbank F, Fournier G, Roussel H. Study of long acting triamcinolone for local injections. Lyon Med. 1971;226:675–677. [PubMed] [Google Scholar]
  • 5.Bum JM, Guyer PB, Langdon L. The spread of solutions injected into the epidural space. Br J Anaesthesiol. 1973;45:338–345. doi: 10.1093/bja/45.4.338. [DOI] [PubMed] [Google Scholar]
  • 6.Bush K, Hillier S. A controlled study of caudal epidural injections. Spine. 1991;16:572. doi: 10.1097/00007632-199105000-00015. [DOI] [PubMed] [Google Scholar]
  • 7.Cuckler JM, Bemini PA, Weisel SW, et al. The use of steroids in the treatment of lumbar radicular pain. J Bone Joint Surg [Am] 1986;67:63–66. [PubMed] [Google Scholar]
  • 8.Derby D.Diagnostic block procedures Spine 198611473704780 [Google Scholar]
  • 9.Dilke T, Burry HC, Grahame R. Extradural corticosteroid injection in management of lumber nerve root compression. Br Med J. 1973;2:635–637. doi: 10.1136/bmj.2.5867.635. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 10.Grogono AW, Woodgate DJ. Index for measuring health. Lancet. 1971;22:1024–1026. doi: 10.1016/s0140-6736(71)90336-9. [DOI] [PubMed] [Google Scholar]
  • 11.Gupta AK, Mital VK, Azmi RU. Observations of the management of lumbosciatic syndromes (sciatica) by epidural saline. J Indian Med Assoc. 1970;54:194–196. [PubMed] [Google Scholar]
  • 12.Kraemer J. Intervertebral disc diseases. 2nd edn. New York: Thieme; 1991. [Google Scholar]
  • 13.Kraemer J. Natural course of intervertebral disc diseases. Spine. 1995;20:635–639. doi: 10.1097/00007632-199503150-00001. [DOI] [PubMed] [Google Scholar]
  • 14.Ridley MG, Kingsley GH, Gibson T, Grahame R. Outpatient lumbar epidural corticosteroid injection in the management of sciatica. Br J Rheumatol. 1988;27:295–299. doi: 10.1093/rheumatology/27.4.295. [DOI] [PubMed] [Google Scholar]
  • 15.Sicard A. Les injections médicamenteuses extra-durales par voie sacrococcygienne. Comptes rendus Hebdomadaires des Séances et Mémoires de la Société de Biologie. 1907;53:396–398. [Google Scholar]
  • 16.Snoek W, Weber H, Jorgensen B. Double blind evaluation of extradural methylprednisolone for herniated lumbar discs. Acta Orthop Scand. 1977;48:535. doi: 10.3109/17453677708994810. [DOI] [PubMed] [Google Scholar]
  • 17.Wittenberg R, Greskoetter K, Steffen R, Schoenfeld B. Ist die epidurale Injektionsbehandlung mit hypotoner Kochsalzlösung sinnvoll? Z Orthop Ihre Grenzgeb. 1990;128:223–226. doi: 10.1055/s-2008-1039504. [DOI] [PubMed] [Google Scholar]

Articles from European Spine Journal are provided here courtesy of Springer-Verlag

RESOURCES