Evidence map›Paper›PMID 41233641›Full record

SynthesisActa neurochirurgica2025

Intra-articular steroid injections for lumbar disk herniation: a systematic review and meta-analysis.

Saran Singh Gill, Pratik Ramkumar, Abith Ganesh Kamath, Sreeraag Kanakala, Akhil Anil, Srikar Reddy Namireddy, Srihan Yalavarthy, Daniele S C Ramsay, Ahmed Salih, Ahkash Thavarajasingam and 6 more

Erratum issuedAbstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Acta neurochirurgica, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

16 authors.

Saran Singh GillImperial College London, London, UK. saran.gill21@imperial.ac.uk.
Pratik RamkumarImperial College London, London, UK.
Abith Ganesh KamathImperial College London, London, UK.
Sreeraag KanakalaImperial College London, London, UK.
Akhil AnilImperial College London, London, UK.
Srikar Reddy NamireddyImperial College London, London, UK.
Srihan YalavarthyImperial College London, London, UK.
Daniele S C RamsayImperial Brain & Spine Initiative, Imperial College London, London, UK.
Ahmed SalihImperial Brain & Spine Initiative, Imperial College London, London, UK.
Ahkash ThavarajasingamImperial Brain & Spine Initiative, Imperial College London, London, UK.
Adrisa PrasharImperial Brain & Spine Initiative, Imperial College London, London, UK.
Sajeenth Vishnu KImperial College London, London, UK.
Tim BeutelImperial Brain & Spine Initiative, Imperial College London, London, UK.
Salvatore RussoImperial College Healthcare NHS Trust, London, UK.
Santhosh G ThavarajasingamImperial Brain & Spine Initiative, Imperial College London, London, UK.
Hariharan Subbiah PonniahImperial Brain & Spine Initiative, Imperial College London, London, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionLumbar disc herniation (LDH) is one of the most common causes of lower back pain, radiculopathy, and functional impairment. Intra-articular (IA) steroid injections, including transforaminal (TFESI), interlaminar (IESI), and caudal (CESI) epidural steroid injections, are commonly administered to alleviate these symptoms when surgery is not indicated or opted for. This systematic review and meta-analysis evaluates the efficacy of these injection modalities in reducing pain and disability in LDH patients.

methodsFollowing PRISMA, 19,664 studies on IA steroid injections for LDH were screened, yielding 41 eligible studies. Random-effects and fixed effects meta-analyses computed pooled standardized mean changes (SMC), depending on heterogeneity (I

resultsTFESI showed strong short-term efficacy, with the greatest pooled NRS improvement of -5.15 (95% CI: -6.59, -3.72, p < 0.001, I

conclusionThis meta-analysis suggests that IA injections may relieve LDH symptoms, with TFESI showing the greatest pain relief and functional improvement. However, significant heterogeneity calls for standardized protocols and further research. Demographic factors minimally influenced outcomes, whereas methodological variability underscores treatment complexity. Future studies should emphasize methodological consistency and personalized approaches to optimize patient outcomes.

Indexed as

Intervertebral Disc DegenerationIntervertebral Disc DisplacementLow Back PainLumbar VertebraeSteroidsHumansInjections, EpiduralInjections, Intra-ArticularTreatment OutcomeSteroidsCESIIA InjectionIESILDHTFESI

Identifiers

PMID41233641
PMCPMC12615523

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.