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KMID : 0361420110350030405
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Journal of Korean Academy of Rehabilitation Medicine
2011 Volume.35 No. 3 p.405 ~ p.411
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The Additional Effect of Hyaluronidase in Lumbar Interlaminar Epidural Injection
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Kim Sang-Beom
Lee Kyeong-Woo
Lee Jong-Hwa
Kim Min-Ah
Kim Byung-Hee
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Abstract
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Objective: To evaluate the eff ect of hyaluronidase in lumbar interlaminar epidural injection (LIEI) for low back pain and sciatica.
Method: Sixty-one patients suff ering from severe low back pain and sciatica were randomly allocated into three groups. Group T (n=18, mean duration of illness: 2.12±1.16 months) received lumbar interlaminar epidural injection (LIEI) with 2 ml triamcinolone (40 mg/ml) and 5 ml bupivacaine (0.25%). Group H (n=16, mean duration of illness: 2.05±1.12 months) received LIEI with 1,500 IU hyaluronidase and 5 ml bupivacaine (0.25%). Group TH (n=27, mean duration of illness: 2.16±1.65 months) received LIEI with 1,500 IU hyaluronidase, 2 ml triamcinolone (40 mg/ml), and 5 ml bupivacaine (0.25%). Th e eff ects were evaluated using the Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) at preinjection and 2 weeks, 4 weeks, and 8 weeks after LIEI.
Results: Pain improved in all groups after 2 weeks (p<0.05). After 8 weeks, there was no signifi cant diff erence in VAS improvement among the 3 groups. However, pain improved in 70.4% of Group TH compared with preinjection, in contrast to 44.4% of Group T and 31.3% of Group H. Th e ODI improved signifi cantly only in Group TH after 8 weeks (p<0.05).
Conclusion: LIEI with triamcinolone and hyaluronidase is more effective for reducing pain after 8 weeks than injection with triamcinolone or hyaluronidase alone.
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KEYWORD
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Hyaluronidase, Low back pain, Sciatica, Epidural injection
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