Epidural Corticosteroid Injections for Radiculopathy and Spinal Stenosis
Authors: Irbaz Bin Riaz, Robert G. Badgett
Journal: Annals of Internal Medicine (2016)

Letters3 May 2016Epidural Corticosteroid Injections for Radiculopathy and Spinal StenosisIrbaz Bin Riaz, MD, MM and Robert G. Badgett, MDIrbaz Bin Riaz, MD, MMFrom University of Arizona, Tucson, Arizona, and University of Kansas School of Medicine, Wichita, Kansas.Search for more papers by this author and Robert G. Badgett, MDFrom University of Arizona, Tucson, Arizona, and University of Kansas School of Medicine, Wichita, Kansas.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L15-0565 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The recent meta-analysis by Chou and colleagues (1) showed that epidural corticosteroids injections were not effective for spinal stenosis. Although the results of this systematic review, sponsored by the Agency for Healthcare Research and Quality (AHRQ), are similar to those of a previous Cochrane meta-analysis (2), juxtaposition of these reviews highlights 2 difficulties for readers attempting to synthesize a conclusion from contradictory reviews. First, regarding the inclusion of trials, 2 rigorous sponsors of meta-analyses, AHRQ and Cochrane, disagreed on the included studies. Of the 5 trials published during a period accessible to both analyses, only 2 (Cuckler ...References1. Chou R, Hashimoto R, Friedly J, Fu R, Bougatsos C, Dana T, et al. Epidural Corticosteroid injections for radiculopathy and spinal stenosis: a systematic review and meta-analysis. Ann Intern Med. 2015;163:373-81. [PMID: 26302454]. doi:10.7326/M15-0934 LinkGoogle Scholar2. Ammendolia C, Stuber KJ, Rok E, Rampersaud R, Kennedy CA, Pennick V, et al. Nonoperative treatment for lumbar spinal stenosis with neurogenic claudication. Cochrane Database Syst Rev. 2013;8:CD010712. [PMID: 23996271] doi:10.1002/14651858.CD010712 CrossrefMedlineGoogle Scholar3. Cuckler JM, Bernini PA, Wiesel SW, Booth RE, Rothman RH, Pickens GT. The use of epidural steroids in the treatment of lumbar radicular pain A prospective, randomized, double-blind study. J Bone Joint Surg Am. 1985;67:63-6. [PMID: 3155742] CrossrefMedlineGoogle Scholar4. Koc Z, Ozcakir S, Sivrioglu K, Gurbet A, Kucukoglu S. Effectiveness of physical therapy and epidural steroid injections in lumbar spinal stenosis. Spine (Phila Pa 1976). 2009;34:985-9. [PMID: 19404172] doi:10.1097/BRS.0b013e31819c0a6b CrossrefMedlineGoogle Scholar5. Manchikanti L, Kaye AD, Manchikanti K, Boswell M, Pampati V, Hirsch J. Efficacy of epidural injections in the treatment of lumbar central spinal stenosis: a systematic review. Anesth Pain Med. 2015;5:e23139. [PMID: 25789241] doi:10.5812/aapm.23139 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From University of Arizona, Tucson, Arizona, and University of Kansas School of Medicine, Wichita, Kansas.Disclosures: Disclosures can also be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L15-0565. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoEpidural Corticosteroid Injections for Radiculopathy and Spinal Stenosis Roger Chou , Robin Hashimoto , Janna Friedly , Rongwei Fu , Christina Bougatsos , Tracy Dana , Sean D. Sullivan , and Jeffrey Jarvik Epidural Corticosteroid Injections for Radiculopathy and Spinal Stenosis Laxmaiah Manchikanti , Alan David Kaye , and Joshua A. Hirsch Epidural Corticosteroid Injections for Radiculopathy and Spinal Stenosis Denis F. Darko Epidural Corticosteroid Injections for Radiculopathy and Spinal Stenosis Timothy P. Maus , Belinda S. Duszynski , and Epidural Corticosteroid Injections for Radiculopathy and Spinal Stenosis Roger Chou , Robin Hashimoto , and Janna Friedly Metrics Cited byLung Cancer Screening with Low-Dose CT: a Meta-Analysis 3 May 2016Volume 164, Issue 9Page: 634-635KeywordsDisclosureForecastingHealth care qualityHealth services researchResearch quality assessmentStenosisSystematic reviews ePublished: 3 May 2016 Issue Published: 3 May 2016 Copyright & PermissionsCopyright © 2016 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...