Do Oral Steroid Dose Packs Predict How Well Epidural Steroid Injections Will Work?
Stopped early
Conditions studied: Lumbar Spine Disc Herniation
In brief
The purpose of this observational study is to show whether a standard oral steroid dose pack can be used as a screening tool to assess the effectiveness of a subsequent epidural steroid injection (ESI). If an oral steroid does not give a patient significant temporary relief of pain from a herniated lumbar disc then an epidural steroid injection will not either. Therefore the risk and expense associated from the interventional pain management procedure for those patients could be avoided and other treatment modalities pursued.
Key facts
- Study ID
- NCT02026726
- Run by
- Dartmouth-Hitchcock Medical Center
- People needed
- 10
- Starts
- 2011-11-01
- Expected to finish
- 2020-08-21
- Last updated by the study team
- 2020-08-25
Who can join
Age: 18 and older. Sex: any. Healthy volunteers: not accepted.
You may qualify if…
- 18 years and older
- Diagnosed by participating physicians during the study enrollment period as having intervertebral disk herniation and persistent symptoms with or without some nonoperative treatment for at least 4 weeks
- Radicular pain (below the knee for lower lumbar herniations, into the anterior thigh for upper lumbar herniations)
- Evidence of nerve-root irritation with a positive nerve-root tension sign (straight leg raise-positive between 30° and 70°) or a corresponding neurologic deficit (asymmetrical depressed reflex, decreased sensation in a dermatomal distribution)
- Undergone either MRI or CT scan showing disc herniation (protrusion, extrusion, or sequestered fragment) at a level and side corresponding to the clinical symptoms
- Patients with multiple herniations can be included if only one of the herniations is considered symptomatic
- Preenrollment nonprocedural care can include: education/counseling, physical therapy, chiropractic therapy, anti-inflammatory medications, opioid analgesics, adjuvant analgesics such as anticonvulsants and antidepressants
You may not qualify if…
- Prior lumbar surgery
- Cauda equina syndrome
- Vertebral fractures
- Spine infection or tumor
- Severe motor deficit
- Inflammatory spondyloarthropathy
- Pregnancy
- Cardiac or pulmonary comorbid conditions contraindicating interventional procedures
- Diabetes
- Inability/unwillingness to have spinal injections
Where it is running
- Dartmouth-Hitchcock Medical Center — Lebanon, New Hampshire, United States
Full record on ClinicalTrials.gov
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