Therapeutic spinal corticosteroid injections for the management of XXXX .

@entity1 @entity32 @entity82 @entity2318 @entity73 @entity51 @entity854 @entity158 @entity614 @entity130 @entity890
Current literature and a recent meta-analysis suggest a favorable role for corticosteroid injections in the nonoperative treatment of @entity614 [70]. The superior results reported in recent literature may be attributable to precise fluoroscopically guided transforaminal placement of injectate close to the disc-nerve root interface and near the dorsal root ganglia, maximizing the therapeutic effect. The favorable results of corticosteroid injections in the treatment of @entity614 caused by a focal disc herniation are consistent with the biochemical construct of @entity158 . The preliminary unfavorable results of therapeutic SNRB for @entity158 caused by epidural or intraneural @entity82 or occurring after @entity130 may relate to a biomechanical rather than a biochemical etiology. Outcomes for acquired cervical or lumbar spinal stenosis are intermediate compared with those observed for @entity890 and @entity2318 or @entity130 . Such results may stem from the multifactorial origin of stenosis symptoms; they may develop from @entity73 , restricted neural glide, @entity32 , or structural @entity130 . Better-designed studies that use strict inclusion criteria that stratify @entity1 into categories according to the mechanism of injury (atraumatic versus traumatic), the presence or absence of @entity51 or @entity854 , and prior treatment will provide the basis for evidence-based treatment decisions. Such an emphasis is just beginning and inevitably will occur. Until then, decisions have to be predicated on the limited and flawed work conducted to date [71]. Nevertheless, the information gleaned from these published reports provides valuable insight not available just a decade ago.
