Evidence map›Paper›PMID 26309483›Full record

ReviewInternational journal of clinical and experimental medicine2015

Epidural injection with or without steroid in managing chronic low back and lower extremity pain: ameta-analysis of ten randomized controlled trials.

Jinshuai Zhai, Long Zhang, Mengya Li, Yiren Tian, Wang Zheng, Jia Chen, Teng Huang, Xicheng Li, Zhi Tian

Abstract readReview
PubMed Full text at PMC
In one paragraph

Review in International journal of clinical and experimental medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 2 pooled it
2.8field-weighted citation impact, top 11% 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

7 citing papers in PubMed, 2 syntheses or guidelines pooled it, 16 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Epidural Steroid Injections for Low Back Pain: A Narrative Review.International journal of environmental research and public health · 2021
    Review
  5. Outcome measurement in patients with low back pain undergoing epidural steroid injection.Turkish journal of physical medicine and rehabilitation · 2019
    Article
  6. Article
  7. Article
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

9 authors at 2 institutions in 1 country.

Jinshuai ZhaiSecond Department of Orthopedics, People's Hospital of Hebei Province China.
Long ZhangSecond Department of Orthopedics, People's Hospital of Hebei Province China.
Mengya LiPublic Health, People's Hospital of Hebei Province China.
Yiren TianSecond Department of Orthopedics, People's Hospital of Hebei Province China.
Wang ZhengSecond Department of Orthopedics, People's Hospital of Hebei Province China.
Jia ChenSecond Department of Orthopedics, People's Hospital of Hebei Province China.
Teng HuangSecond Department of Orthopedics, People's Hospital of Hebei Province China.
Xicheng LiSecond Department of Orthopedics, People's Hospital of Hebei Province China.
Zhi TianSecond Department of Orthopedics, People's Hospital of Hebei Province China.
Hebei Medical University · CNHospital of Hebei Province · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundChronic low back and lower extremity pain is mainly caused by lumbar disc herniation (LDH) and radiculitis. Various surgery and nonsurgical modalities, including epidural injections, have been used to treat LDH or radiculitis. Therefore, we conducted this meta-analysis to assess the effects of the two interventions in managing various chronic low and lower extremity pain.

methodsA systematic literature search was conducted to identify randomized controlled trials (RCTs) which compared the effect of local anesthetic with or without steroids. The outcomes included pain relief, functional improvement, opioid intake, and therapeutic procedural characteristics. Pooled estimates were calculated using a random-effects or fixed-effects model, depending on the heterogeneity between the included studies.

results10 RCTs (involving 1111 patients) were included in this meta-analysis. The pooled results showed that 41.7% of patients who received local anesthetic with steroid (group 1) and 40.2% of patients who received local anesthetic alone (group 2) had significant improvement in pain relief. And the Numeric Rating Scale pain scales were significantly reduced by 4.09 scores (95% CI: -4.26, -3.91), and 4.12 (95% CI: -4.35, -3.89) scores, respectively. Similarly, 39.8% of patients in group 1 and 40.7% of patients in group 2 achieved significantly improved functional status. The Oswestry Disability Index in the two groups were reduced by 14.5 (95% CI: -15.24, -13.75) and 12.37 (95% CI: -16.13, -8.62), respectively. The average procedures per year in group 1 was 3.68 ± 1.17 and 3.68 ± 1.26 in group 2 with an average total relief per year of 31.67 ± 13.17 weeks and 32.64 ± 13.92 weeks, respectively. The opioid intake decreased from baseline by 8.81 mg (95% CI: -12.24, -5.38) and 16.92 mg (95% CI: -22.71, -11.12) in the two groups, respectively.

conclusionThis meta-analysis confirms that epidural injections of local anesthetic with or without steroids have beneficial but similar effects in the treatment of patients with chronic low back and lower extremity pain.

Indexed as

Chronic low back painepidural injectionslocal anestheticlower extremity painmeta-analysissteroids

Identifiers

PMID26309483
PMCPMC4538092
OpenAlexW1937917489

What OpenQuestion holds

Textmetadata
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.