{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T07:59:09Z","timestamp":1790150349706,"version":"4.0.1"},"reference-count":32,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Pain"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The efficacy of caudal injections for patients with acute sciatica remains controversial. The DEXHIA study was designed to evaluate whether ultrasound\u2010guided caudal injection of dexamethasone provides superior clinical outcomes compared with saline placebo.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective, randomized, placebo\u2010controlled, double\u2010blind trial included adult patients with sciatica secondary to lumbar disc herniation of less than 3 months' duration. Participants were randomly assigned in a 1:1 ratio to receive either 16\u2009mg of dexamethasone (4\u2009mL) diluted with 16\u2009mL of saline (DEXA group) or 20\u2009mL of saline alone (PLACEBO group), administered by ultrasound\u2010guided caudal epidural injection. The primary outcome was the change in the Oswestry Disability Index (ODI) at 3\u2009weeks. Secondary outcomes included leg pain and low back pain assessed by visual analogue scale (VAS), health\u2010related quality of life (SF\u201036), need for repeat epidural injection, and need for lumbar surgery. Clinical assessments were performed at 3\u2009weeks, 3 months, and 6 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 106 patients were randomized, with 53 participants assigned to each treatment group. The primary endpoint was not met, as the improvement in ODI at 3\u2009weeks did not differ significantly between groups (mean change: \u22129.5\u2009\u00b1\u20094.4 in the DEXA group versus \u221213.8\u2009\u00b1\u20094.4 in the PLACEBO group;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.18). No significant differences were observed for any relevant secondary outcome at any follow\u2010up time point. During the 6\u2010month follow\u2010up, 34 patients in the DEXA group and 30 patients in the PLACEBO group underwent a second, non\u2010blinded injection of dexamethasone (ns). Lumbar surgery was performed in 10 patients in the DEXA group and nine patients in the PLACEBO group (ns). Injection\u2010related adverse events were mild and transient but occurred more frequently in the DEXA group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Caudal injection of soluble dexamethasone conferred no clinical benefit over saline placebo in patients with acute sciatica.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance Statement<\/jats:title>\n                    <jats:p>Epidural injections are widely used worldwide for the treatment of resistant sciatica and have been extensively studied in multiple meta\u2010analyses. However, their clinical value remains debated due to the limited methodological quality of most available studies. We conducted a methodologically rigorous randomized, placebo\u2010controlled trial, which yielded negative results. These findings question the efficacy of caudal epidural injection of a non\u2010particulate corticosteroid administered via a remote (sacrococcygeal) approach for disc\u2010related sciatica.<\/jats:p>\n                    <jats:p>\n                      <jats:bold>Trial Registration:<\/jats:bold>\n                      The trial was registered under European Clinical Trials No. 2021\u2010001571\u201017 and\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link>\n                      identifier NCT05000658\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejp.70373","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T14:30:26Z","timestamp":1788445826000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["No Efficacy of Dexamethasone Injections for Acute Sciatica: A Double\u2010Blind Randomized Study Versus Saline"],"prefix":"10.1002","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5131-8524","authenticated-orcid":false,"given":"Yves","family":"Maugars","sequence":"first","affiliation":[{"name":"Facult\u00e9 de M\u00e9decine de Nantes Universit\u00e9 de Nantes  Nantes France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christelle","family":"Volteau","sequence":"additional","affiliation":[{"name":"Direction de la Recherche, CHU de Nantes  Nantes France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Korner","sequence":"additional","affiliation":[{"name":"Pharmacovigilance, Direction de la Recherche CHU de Nantes  Nantes France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Arnolfo","sequence":"additional","affiliation":[{"name":"Rheumatology Department University Nantes Hospital  Nantes 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