TABLE 5.

Comparative-effectiveness of Dexamethasone Versus Particulate Steroids in the Treatment of Lumbar Radiculopathy With Interlaminar Epidural Steroid Injection and Caudal Injection Technique

References	Study Type	Injection Technique	Dexamethasone Dose (mg)	Comparator Dose	Patient Exposure	Results
Datta and Upadhyay73	Randomized trial comparing dexamethasone, triamcinolone and methylprednisolone mixed with bupivacaine to bupivacaine alone in patients with radicular pain secondary to lumbar disc herniation	Caudal	15	80 mg methylprednisolone 80 mg triamcinolone 10-15 mL bupivacaine 0.25% alone (similar bupivacaine volume to steroid treatment groups)	163	All 3 steroid groups had greater pain relief than the nonsteroid control group through 12 wk, with no differences between groups All steroid groups had less paravertebral muscle spasm At 12 wk but not 6 wk, the triamcinolone and methylprednisolone groups had greater improvement in finger-to-floor range of motion than the dexamethasone and bupivacaine-only groups Mean VAS pain score at 12 wk: bupivacaine alone (6.2), methylprednisolone+bupivacaine (4.9), triamcinolone+bupivacaine (4.8), dexamethasone+bupivacaine (5.2)
Kim & Brown74	Randomized controlled trial comparing dexamethasone and methylprednisolone in patients with lumbar radiculopathy	IL	15	80 mg methylprednisolone	60	VAS pain score reduction: dexamethasone 19.7% decrease; methylprednisolone 27.2% decrease; difference not statistically significant
Kim et al75	Retrospective crossover study in patients who previously underwent an ESI with triamcinolone	Caudal, IL, or TFESI	10	40 mg triamcinolone	162	62.6% reported that triamcinolone provided greater benefit than dexamethasone (P=0.004)

ESI indicates Epidural steroid injection; IL, interlaminar; TFESI, transforaminal epidural steroid injection; VAS, Visual Analog Scale.