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KMID : 0363120210340010114
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Korean Journal of Pain
2021 Volume.34 No. 1 p.114 ~ p.123
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Ultrasound-guided epidural block in axial spondyloarthritis patients with limited spine mobility: a randomized controlled trial
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Elsaman AM
Hamed A
Radwan AR
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Abstract
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Background: Evaluation of the effectiveness of caudal epidural injection on pain, spine mobility, disease activity, and activity of daily living in axial spondyloarthritis (SpA) patients.
Methods: A total sample of 47 patients were registered in this study. They were randomly assigned into 2 groups; Group I received caudal epidural injections, ultrasound-guided, with 1% lidocaine hydrochloride mixed with triamcinolone, whereas Group II did not receive any injections. All participants fulfilled the ASAS criteria for axial SpA. Outcome measures were as follows: visual analogue scale, Oswestry disability index (ODI), modified Schober test, lateral lumbar flexion, and Ankylosing Spondylitis Disease Activity Score (ASDAS) with assessment at baseline, 2 weeks, and 8 weeks post-treatment. This clinical trial was registered on clinicaltrials.gov under the number NCT04143165.
Results: There was a significant difference between both groups regarding pain, ODI, spine mobility and ASDAS scores in favor of group I. This effect was at its maximum after 2 weeks. Despite the decline of this effect after 2 months, the difference between the groups remained significant. Higher disease activity, younger age, and shorter disease duration were associated with better outcomes.
Conclusions: Epidural injection of lidocaine and triamcinolone is a cost effective and a practical technique for controlling pain, as well as improving the function of the spine and disease activity scores in axial SpA patients with acceptable complications and relatively sustained effect.
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KEYWORD
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Back Pain, Epidural, Injections, Lidocaine, Nerve Block, Pain Management, Spine, Spondylarthritis, Spondylitis, Triamcinolone
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