Evidence map›Paper›PMID 18665021›Full record

Trial reportSpine2008

A randomized placebo-controlled trial of single-dose IM corticosteroid for radicular low back pain.

Benjamin W Friedman, David Esses, Clemencia Solorzano, Hong K Choi, Michael Cole, Michelle Davitt, Polly E Bijur, E J Gallagher

Open access · greenAbstract readComparative StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Spine, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 2 pooled it
2.4field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

13 citing papers in PubMed, 2 syntheses or guidelines pooled it, 50 citations in OpenAlex.

  1. Systemic corticosteroids for radicular and non-radicular low back pain.The Cochrane database of systematic reviews · 2022
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

Benjamin W FriedmanDepartment of Emergency Medicine, Albert Einstein College of Medicine, Bronx, NY 10467, USA. befriedm@montefiore.org
David Esses
Clemencia Solorzano
Hong K Choi
Michael Cole
Michelle Davitt
Polly E Bijur
E J Gallagher
Albert Einstein College of Medicine · USYeshiva University · USMontefiore Medical Center · US

Funding

Optimizing the Emergency Department diagnosis and treatment of migrainesK23NS051409 · NINDS · MONTEFIORE MEDICAL CENTER (BRONX, NY) · PI FRIEDMAN, BENJAMIN WOLKIN · 2006 to 2010
$729k
NINDS NIH HHS 1K23NS051409NINDS NIH HHS K23 NS051409
6 · The paper itself

Abstract

STUDY

designA randomized, double-blind, placebo-controlled trial of patients with radicular low back pain who present to an emergency department (ED) within 1 week of pain onset.

objectiveWe hypothesized that a single intramuscular 160 mg dose of methylprednisolone acetate would improve pain and functional outcomes 1 month after ED discharge if the corticosteroid were administered early in disease symptomotology. SUMMARY OF BACKGROUND DATA: Parenteral corticosteroids are not recommended for acute, radicular low back pain, though their role in this disease process is ill-defined. To date, this medication class has only been studied in a highly selected group of patients requiring hospitalization. METHODS.: Adults between the ages of 21 and 50 who presented to an ED with low back pain and a positive straight leg raise test were enrolled. The primary outcome was change in pain intensity on an 11 point numerical rating scale 1 month after ED visit. Secondary outcomes 1 month after ED discharge included analgesic use, functional disability, and adverse medication effects.

resultsSix hundred thirty-seven patients were approached for participation, 133 were eligible, and 82 were randomized. Baseline characteristics were comparable between the groups. The primary outcome, a comparison of the mean improvement in pain intensity, favored methylprednisolone by 1.3 (P = 0.10). Some secondary outcomes favored methylprednisolone, such as use of analgesic medication within the previous 24 hours (22% vs. 43%, 95% CI for difference of 20%: 0%-40%) and functional disability (19% vs. 49%, 95% CI for difference of 29%: 9%-49%). Adverse medication effects 1 week after ED discharge were reported by 32% of methylprednisolone and 24% of placebo patients (95% CI for difference of 9%: -12% to 30%).

conclusionThis study was a negative study, though there was a suggestion of benefit of methylprednisolone acetate in a population of young adults with acute radicular low back pain. Further work with a larger sample of patients is needed.

Indexed as

Adrenal Cortex HormonesAdultDouble-Blind MethodFemaleHumansInjections, IntramuscularLow Back PainMaleMethylprednisoloneMethylprednisolone AcetateMiddle AgedRadiculopathyAdrenal Cortex HormonesMethylprednisoloneMethylprednisolone Acetate

Identifiers

PMID18665021
PMCPMC2597789
OpenAlexW1994528231

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.