Study of efficacy of epidural methylprednisolone acetate and triamcinolone acetate for treatment of low back pain and radiculopathy

Background: Epidural steroids have been proven to be one of the most effective non-operative managements of back pain. The present study entailed evaluation of the efficacy of epidural methylprednisolone acetate and triamcinolone acetate for treatment of low back pain and radiculopathy.Methods: The two groups of 25 participants, formed on the basis of the injectable epidural steroid used {80mg of methylprednisolone acetate (group 1) or 40mg of triamcinolone acetate (group 2)}, were enrolled after following due selection criteria. After detailed history taking, examination and requisite investigations, 15 ml volume of the drug was injected epidurally with the patient lying in lateral position. The patients were followed-up at 3 weeks, 6 weeks and 3 months and pain assessment and percentage of pain relief was noted in comparison with the level of pain before epidural injection. Sleep quality, activity score, days in bed, analgesic requirement, complications and requirement of surgical intervention were all assessed at each follow-up.Results: The mean pain score was significantly less in group 1 after 6 weeks and 3 months period, with 60% in group 1 having “good” pain relief, while 69.56% amongst group 2 participants reported “fair” pain relief. Eighty four percent group 1 participants required 2 injections, while 64% participants in group 2 required 3 injections. There was overall improvement in the activity score, quality of sleep and decrease in bed rest and analgesic requirement.Conclusions: Epidural steroid therapy is highly efficacious and methylprednisolone acetate is more effective than triamcinolone acetate; with negligible complications.

The Effects of Methylprednisolone Acetate that is Injected into the Epidural Space on the Hypothalmus - Pituitary - Adrenal Axis / 대한마취과학회지

Nowdays steroid injection into the epidural space is increasing gradually by pain clinic physician in order to control of low back and radiculating pain. But, there are a few reports about the effect of methylprednisolone that is injected into the epidural space on the plasma cortisol levels. So we undertook to determine the effect of epidural methylprednisolone acetate(Depomedrol) on the hypothalamus-pituitaryadrenal axis by checking plamsa cortisol levels. 9 patients were given 80 mg of methylprednisolone acetate and 10 ml of 0.25% bupicaine epidurally 3 times of injection at weekly intervals and checked the plasma cortisol levels of 1 hour before and after each injection respectively. The levels of plasma cortisol were also checked at first and 4th week after the last injection. The results are as follows: The baseline plasma cortisol level is 11.21+/-6.38mg%. The plasma cortisol levels of 1 hour before and after 2nd injection are 3.94+/-5.38 and 4.11+/-7.10mg%. The plasma cortisol levels of 1 hour before and after 3rd injection are 2.01+/-1.33 and 2.90+/-4.31mg%. The palsma cortisol level of 1st week after the last injection is 1.76+/-1.03mg%. The plasma cortisol level of 4th week after the last injection is 7.45+/-2.38mg%.

Experimental Cystic Disease of the Kidney Morphometric and Ultrastructural Studies in Special Reference to its Histogenesis / 대한비뇨기과학회지

Cystic lesions of the kidney were experimentally induced by a single injection of methylprednisolone acetate(MPA), 20mg/kg, and morphometric analysis and ultrastructural observations by means of trans. mission and scanning electron microscopes were carried out after 1,2,3 and 4 weeks to clarify the nature of the cysts and their Histogenesis. l. The cystic lesions developed by administration of MPA were categorized into tubular and glomerular cysts ; the former underwent gradual regression of its number after the first week together with reduction of its ratio to the renal volume, whereas the latter progressed. 2. The subcapsular cystic structures(average diameter of ll0um) was originated from the dilated collecting tubules by 180 degree rotation in regard with abnormality in maturation process of nephorgenic activity. 3. Abnormalities of both proximal and distal convoluted tubules were reflected by increases of tubular diameter(l.54~3.55 times) and nuclear density(1.77~l.72 times), representing a compensatory dilatation of tubular lumen in association with shortening of tubular length. 4.Convolution of tubules was reduced and parallel to the shortening of tubular length. The above morphometric and ultrastructural features support that cystic lesion in the subcapsular portion induced by administration of MPA arises from the subcapsular collecting tubules by maturation arrest of nephorgenic activity.

The Treatment of Unicameral Bone Cysts by Topical Injection of Methylprednisolone Acetate: Reaport of 4 Cases / 대한정형외과학회잡지

Unicameral bone cysts have been treated by variable surgical methods, but reported with high recurrent rates. Recently, the treatment of unicameral bone cyst by topical injection of methylprednisolone acetate has been reported with excellent results. The authors treated 4 cases of the unicameral bone cyst by topical injection of methylprednisolone acetate and followed up for 3 years and 5 months to 4 years. The results were as follows: l. 3 cases were healed completely with obliteration of cyst cavity and 1 case was in residual healing process. 2. If the cavity persists or recurrs, it seems possible to cure the cyst by repeated local injection.