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The
caudal approach with an adjustable catheter was found to be superior to other
epidural techniques as it provided long-term pain relief in patients with acute
radicular pain.
According to the recent
study published in 'Pain and Therapy', the caudal approach with an adjustable
catheter was found to be a novel, safe and extremely target-specific treatment
for patients with acute radicular pain. It allows the use of small doses of
corticosteroids and also makes the procedure free from the risk of significant
complications.
Acute lumbosacral radicular syndrome is a
medical condition with difficult management. Epidural steroid injections are
useful for the management of herniated disc and radiculitis; the transforaminal
approach is generally used due to its significant effectiveness and
target-specificity. However, the transforaminal approach may result in
permanent lower extremity paralysis. The caudal approach with an adjustable
catheter has shown promising results in adhesiolysis in chronic low back pain.
However, there is lack of data depicting its efficacy in acute radicular pain.
Maria Clemente et al. conducted the study to
examine the clinical efficacy of epidural steroid injection by a caudal
approach with an adjustable catheter in patients suffering from severe acute
radicular pain.
The study included 55 patients with severe
acute radiculopathy. The patients received epidural steroid injection by an
epidural catheter whose tip can be directed laterally on the selected site.
After 1, 3, 6, and 12 months, pain relief, analgesic consumption and the
Numerical rating scale (NRS) were observed. The secondary end-points were
functional recovery (FR) and analgesic consumption (AC).
NRS score showed a considerable reduction,
which was constant every 12 months. After one month, the pain relief was good;
which further got better after three months. Inadequate pain relief was
observed in a few patients and pain relapsed in only three patients. More than
70% of patients were found to be drug-free at 12 months. The author mentioned
the need for further studies or clinical trials to confirm these preliminary
findings.
Pain and Therapy
A Novel Application of an Adjustable Catheter in Acute Radicular Pain Management
Maria Clemente et al.
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