ArticleBrain & spine2026
Early assessment of physical capacity and pain is associated with 1-month response following epidural steroid injection in patients with sciatica due to degenerative lumbar disorders.
Article in Brain & spine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Epidural steroid injections (ESI) are widely used to treat sciatica from degenerative lumbar disorders (DLD), but objective functional improvement and the predictive value of early response remain unclear. Research question: Does ESI improve pain and physical capacity in DLD-related sciatica, and can early achievement of the minimum clinically important difference (MCID) predict outcomes at 1 month? Methods: In this prospective study, 45 patients with DLD-related sciatica were evaluated before and after ESI at 1 day (1D), 1 week (1W), and 1 month (1M). Physical capacity was measured using a smartphone-based 6-min walking test (6WT); pain was assessed with Visual Analogue Scale scores for leg and back pain (VAS Leg, VAS Back). Agreement of MCID classification across follow-ups was analyzed with Cochran's Q and Fleiss' kappa. Sensitivity, specificity, and predictive values evaluated whether early MCID predicted outcomes at 1M. Results: Forty-five patients (mean age 51 ± 13 years; 53% female) were included. Walking distance increased from 457 m (SD 92; z -1.0 ± 1.1) at baseline to 523 m (SD 71; z -0.5 ± 1.1) at 1D (p < 0.001), with no further change to 1M. MCID classification showed good-to-excellent agreement (Cochran's Q p > 0.05; Fleiss' κ > 0.6). Achieving MCID within 1W predicted MCID at 1M with 100% sensitivity for VAS Leg and 80% for walking distance. Discussion and conclusion: 6WT performed within one week is associated with treatment success at one month, supporting its role as a valuable objective tool in early outcome assessment.
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