The Additional Effect of Hyaluronidase in Lumbar Interlaminar Epidural Injection.
10.5535/arm.2011.35.3.405
- Author:
Sang Beom KIM
1
;
Kyeong Woo LEE
;
Jong Hwa LEE
;
Min Ah KIM
;
Byung Hee KIM
Author Information
1. Department of Physical Medicine and Rehabilitation, Dong-A University College of Medicine, Busan 602-715, Korea. kwlee65@dau.ac.kr
- Publication Type:Original Article ; Randomized Controlled Trial
- Keywords:
Hyaluronidase;
Low back pain;
Sciatica;
Epidural injection
- MeSH:
Bupivacaine;
Humans;
Hyaluronoglucosaminidase;
Injections, Epidural;
Low Back Pain;
Sciatica;
Stress, Psychological;
Triamcinolone
- From:Annals of Rehabilitation Medicine
2011;35(3):405-411
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To evaluate the effect of hyaluronidase in lumbar interlaminar epidural injection (LIEI) for low back pain and sciatica. METHOD: Sixty-one patients suffering from severe low back pain and sciatica were randomly allocated into three groups. Group T (n=18, mean duration of illness: 2.12+/-1.16 months) received lumbar interlaminar epidural injection (LIEI) with 2 ml triamcinolone (40 mg/ml) and 5 ml bupivacaine (0.25%). Group H (n=16, mean duration of illness: 2.05+/-1.12 months) received LIEI with 1,500 IU hyaluronidase and 5 ml bupivacaine (0.25%). Group TH (n=27, mean duration of illness: 2.16+/-1.65 months) received LIEI with 1,500 IU hyaluronidase, 2 ml triamcinolone (40 mg/ml), and 5 ml bupivacaine (0.25%). The effects were evaluated using the Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) at preinjection and 2 weeks, 4 weeks, and 8 weeks after LIEI. RESULTS: Pain improved in all groups after 2 weeks (p<0.05). After 8 weeks, there was no significant difference in VAS improvement among the 3 groups. However, pain improved in 70.4% of Group TH compared with preinjection, in contrast to 44.4% of Group T and 31.3% of Group H. The ODI improved significantly only in Group TH after 8 weeks (p<0.05). CONCLUSION: LIEI with triamcinolone and hyaluronidase is more effective for reducing pain after 8 weeks than injection with triamcinolone or hyaluronidase alone.
