CC Nov 2015 Epidural steroid injection for back pain

echoecho's version from 2015-11-16 13:56


Question Answer
Epidural steroid injections are a common treatment modality for what syndromes?back pain
What was the Medical expenditures for lumbar epidural steroid injections in 2007?$175 million
Research on epidural steroid injection effectiveness does not consistently demonstrate a benefit when compared with what 2 modalities?1) lidocaine injection 2) watchful waiting
A Medical investigation in 2012 found that up to ____% of claims for epidural steroid injections did not meet medical necessity?35
Why is comparison of trials difficult?1) due to lack of standardization 2) due to a variety of injection steroids 3) due to a variety of injection approaches
A Cochrane reviewed included 18 studies in a meta-analysis (n=1,179). Only ___ or the 18 studies found a significant decrease in back pain with epidural steroid injection?5
List the side effects of epidural steroid injections?1) headache 2) dizziness 3) pain
Overall, was there sufficient evidence to recommend epidural injection for subacute and chronic low back pain?no
Comment on randomized trials using epidural steroid injections in spinal stenosis patients?no evidence of benefit
Studies of epidural steroids for short-term pain relief in multiple conditions showed ____ results?negative
Studies in which the placebo treatment involved an epidural injection of saline or local anesthetic were _____ (more vs. less) likely to show benefit than studies in which the placebo was a soft tissue injection, suggesting that some benefit may result from nonspecific effects of epidural injections?less
High-quality studies with long-term follow-up found no benefit lasting beyond ___ months?3
*** A recent high-quality randomized trial found "in the treatment of lumbar spinal stenosis what in comparison between epidural injection of glucocosteroids plus lidocaine vs. lidocaine alone?the glucocosteroids plus lidocaine offered minimal or no short-term benefit as compared with epidural injection of lidocaine alone
Why does the American Academy of Neurology not recommend use of epidural steroid injections for long-term pain control?due to a lack of evidence for pain relief of > 3 months duration
Patients who do not respond to an initial injection are unlikely to respond to additional injections in the next ___ weeks?6
*** SUMMARY = For the treatment of lumbar spinal stenosis, epidural injection of corticosteroids offers minial or no short-term benefit compared to what?an injection of lidocaine alone
*** SUMMARY = Did Cochrane review find a few studies that demonstrate any benefit of epidural steroid injection for back pain?yes
*** SUMMARY = A substantial % of epidural steroid injections performed on Medicare patients in 2012 ______ (did vs. didn't) meet criteria for medical necessity?did not