The preliminary results of a comparative effectiveness evaluation of adhesiolysis and caudal epidural injections in managing @entity1643 secondary to XXXX : a randomized, equivalence controlled trial.

@entity1 @entity1643 @entity612 @entity5935 @entity134 @entity3303 @entity158 @entity230 @entity717 @entity2827
BACKGROUND: Lumbar surgery and epidural injections for @entity612 are the most commonly performed interventions in the United States. However, there is only moderate evidence to the effectiveness of surgery and caudal epidural injections. The next sequential step is adhesiolysis and hypertonic neurolysis with targeted delivery. There have not been any randomized trials evaluating the effectiveness of percutaneous adhesiolysis and targeted delivery of local anesthetic, @entity134 and hypertonic @entity2827 solution in lumbar @entity612 . STUDY DESIGN: A randomized, equivalence, controlled trial. SETTING: An interventional @entity158 management practice, a specialty referral center, a private practice setting in the United States. OBJECTIVES: To evaluate the effectiveness of percutaneous epidural adhesiolysis in @entity1 with @entity1643 with lumbar central @entity612 and compare with fluoroscopically directed caudal epidural injections. METHODS: @entity1 were randomly assigned to one of 2 groups with 25 @entity1 in each group. Group I @entity1 received caudal epidural injections with catheterization up to S3 with local anesthetic, 0.9% @entity2827 solution, non-particulate betamethasone and served as the control group. Group II @entity1 received percutaneous adhesiolysis with targeted delivery and injection of @entity3303 , 10% hypertonic @entity2827 solution, and non-particulate @entity5935 and formed the intervention group. Randomization was performed by computer-generated random allocation sequence by simple randomization. OUTCOMES ASSESSMENT: Multiple outcome measures were utilized including the Numeric Rating Scale (NRS), the @entity717 Index 2.0 (ODI), employment status, and opioid intake with assessment at 3, 6, and 12 months post treatment. Significant @entity158 relief was described as 50% or more, whereas significant improvement in the disability score was defined as a reduction of 40% or more. RESULTS: This evaluation showed significant @entity158 relief (>or= 50%) in 76% of the @entity1 at one year follow-up in the adhesiolysis group compared to 4% of the @entity1 in the control group. LIMITATIONS: The results of this study are limited by the lack of a placebo group, the fact that it is a preliminary report, and there are only 25 @entity1 in each group. CONCLUSIONS: With significant @entity158 relief in 76% of @entity1 , percutaneous adhesiolysis utilizing local anesthetic, @entity230 and hypertonic @entity2827 solution may be effective in @entity1 with @entity1643 with @entity612 .
