title: Comparative effectiveness of lumbar epidural steroid injections using particulate vs. non-particulate steroid: an intra-individual comparative study.
abstract: OBJECTIVE
  To perform an intra-individual comparison for the effectiveness of lumbar epidural steroid injection (ESI) between injections using particulate (triamcinolone) and non-particulate (dexamethasone) steroid.
  
  
  METHODS
  This study included 162 patients(M:F = 60:102, mean age 66.3 years) who underwent lumbar ESI using dexamethasone(ESI_DEXA) from April 2013 to May 2013 and who had previously underwent lumbar ESI using triamcinolone(ESI_TRIAM) within 1 year. Degree of relative satisfaction, injection-free interval and injection frequency were determined. Subgroup analyses were also done according to the diagnosis, approach-methods, patients' ages and sex.
  
  
  RESULTS
  Eighty-seven of 139 patients (62.6 %) responded that the effect of ESI_TRIAM was better than that of ESI_DEXA (p = 0.004). In the four subgroups-patients with herniated intervertebral disc (HIVD), who underwent transforaminal ESI, were under age 70 and were male patients-the proportion of patients who preferred ESI_TRIAM was significantly greater than the proportion patients who preferred ESI_DEXA in terms of relative satisfaction (p < 0.05). The injection-free interval of ESI_TRIAM was significantly longer than that of ESI_DEXA (p = 0.01). In the subgroup analyses, the patient groups HIVD, who underwent transforaminal ESI, under age 70 and female patients with longer injection-free interval of ESI_TRIAM than ESI_DEXA were statistically significant (p < 0.05). Other factors were not significant.
  
  
  CONCLUSIONS
  The relative satisfaction with ESI_TRIAM was significantly better than that with ESI_DEXA in the same patient, and the injection-free interval after ESI_TRIAM was significantly longer than that after ESI_DEXA.
authors.affiliation: Department of Radiology, Seoul National University Bundang Hospital, 82 Gumi-ro, 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, South Korea.
authors.forename: Ji Young
authors.initials: JY
authors.lastname: Kim
authors.affiliation: Department of Radiology, Seoul National University Bundang Hospital, 82 Gumi-ro, 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, South Korea. joonwoo2@gmail.com.
authors.forename: Joon Woo
authors.initials: JW
authors.lastname: Lee
authors.affiliation: Department of Radiology, Seoul National University Bundang Hospital, 82 Gumi-ro, 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, South Korea.
authors.forename: Geun Young
authors.initials: GY
authors.lastname: Lee
authors.affiliation: Department of Radiology, Seoul National University Bundang Hospital, 82 Gumi-ro, 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, South Korea.
authors.forename: Eugene
authors.initials: E
authors.lastname: Lee
authors.affiliation: Department of Radiology, Seoul National University Bundang Hospital, 82 Gumi-ro, 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, South Korea.
authors.forename: Chang Jin
authors.initials: CJ
authors.lastname: Yoon
authors.affiliation: Department of Radiology, Seoul National University Bundang Hospital, 82 Gumi-ro, 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, South Korea.
authors.forename: Heung Sik
authors.initials: HS
authors.lastname: Kang
mesh_terms: D000368:Aged; D003907:Dexamethasone / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007268:Injections, Epidural; D007405:Intervertebral Disc Displacement / Q000150:complications; D017116:Low Back Pain / Q000188:drug therapy* / Q000209:etiology; D008159:Lumbar Vertebrae; D008297:Male; D016896:Treatment Outcome; D014221:Triamcinolone / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D005938:Glucocorticoids; D014221:Triamcinolone; D003907:Dexamethasone
keywords: Effectiveness; Epidural; Injection; Spine; Steroid