{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T08:23:30Z","timestamp":1740126210304,"version":"3.37.3"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"7","funder":[{"DOI":"10.13039\/100007188","name":"Uniformed Services University","doi-asserted-by":"publisher","award":["HU00011920011"],"award-info":[{"award-number":["HU00011920011"]}],"id":[{"id":"10.13039\/100007188","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Transforaminal epidural steroid injections (TFESI) are commonly employed to treat lumbosacral radiculopathy. Despite anti-inflammatory properties, the addition of 3% hypertonic saline has not been studied.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Compare the effectiveness of adding 0.9% NaCl (N-group) vs. 3% NaCl (H-group) in TFESI performed for lumbosacral radiculopathy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This retrospective study compared TFESI performed with lidocaine, triamcinolone and 0.9% NaCl vs. lidocaine, triamcinolone and 3% NaCl. The primary outcome was the proportion of patients who experienced a\u2009\u2265\u200930% reduction in pain on a verbal rating scale (VRS; 0\u2013100) at 3\u2009months. Secondary outcome measures included the proportion of patients who improved by at least 30% for pain at 1 and 6 months, and who experienced \u226515% from baseline on the Oswestry disability index (ODI) at follow-up.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The H-group experienced more successful pain outcomes than the N-group at 3\u2009months (59.09% vs. 41.51%; P\u2009=\u2009.002) but not at 1\u2009month (67.53% vs. 64.78%; P\u2009=\u2009.61) or 6\u2009months (27.13% vs 21.55%: P\u2009=\u2009.31). For functional outcome, there was a higher proportion of responders in the H-group than the N-group at 3\u2009months (70.31% vs. 53.46%; P\u2009=\u2009.002). Female, age \u2264 60\u2009years, and duration of pain \u2264 6\u2009months were associated with superior outcomes at the 3-month endpoint. Although those with a herniated disc experienced better outcomes in general with TFESI, the only difference favoring the H-group was for spondylolisthesis patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>3% hypertonic saline is a viable alternative to normal saline as an adjunct for TFESI, with randomized studies needed to compare its effectiveness to steroids as a possible alternative.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Registration<\/jats:title>\n                  <jats:p>Thai Clinical Trials Registry ID TCTR 20231110006<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/pm\/pnae019","type":"journal-article","created":{"date-parts":[[2024,3,22]],"date-time":"2024-03-22T03:20:12Z","timestamp":1711077612000},"page":"451-458","source":"Crossref","is-referenced-by-count":0,"title":["Comparative-effectiveness study evaluating outcomes for transforaminal epidural steroid injections performed with 3% hypertonic saline or normal saline in lumbosacral radicular pain"],"prefix":"10.1093","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1107-4721","authenticated-orcid":false,"given":"Sithapan","family":"Munjupong","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Phramongkutklao Hospital and Phramongkutklao College of Medicine , Bangkok, 10400, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wanwipha","family":"Malaithong","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Phramongkutklao Hospital and Phramongkutklao College of Medicine , Bangkok, 10400, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ekasak","family":"Chantrapannik","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Phramongkutklao Hospital and Phramongkutklao College of Medicine , Bangkok, 10400, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Poomin","family":"Ratchano","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Phramongkutklao Hospital and Phramongkutklao College of Medicine , Bangkok, 10400, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nuj","family":"Tontisirin","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University , Bangkok, 10400, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven P","family":"Cohen","sequence":"additional","affiliation":[{"name":"Northwestern University Feinberg School of Medicine Departments of Anesthesiology, Neurology, Physical Medicine & Rehabilitation, Psychiatry and Neurosurgery, , Chicago, IL 60611, United States"},{"name":"Johns Hopkins School of Medicine Departments of Anesthesiology, Neurology, Physical Medicine & Rehabilitation and Psychiatry and Behavioral Sciences, , Baltimore, MD, United States"},{"name":"Walter Reed National Military Medical Center Departments of Physical Medicine & Rehabilitation and Anesthesiology, , Uniformed Services University of the Health Sciences, Bethesda, MD 20889, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,3,21]]},"reference":[{"issue":"4","key":"2024070507511888400_pnae019-B1","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1093\/bja\/aem238","article-title":"Sciatica: a review of history, epidemiology, pathogenesis, and the role of epidural steroid injection in management","volume":"99","author":"Stafford","year":"2007","journal-title":"Br J Anaesth"},{"issue":"4","key":"2024070507511888400_pnae019-B2","first-page":"CD013577","article-title":"Epidural corticosteroid injections for lumbosacral radicular 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