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Clinical outcomes of chronic radicular lumbosacral pain following epidural triamcinolone injection

Abstract

Link of Video Abstract: https://youtu.be/p0XGijpKxwE

 

Introduction: Chronic radicular lumbosacral pain or CRLP is a unilateral or bilateral subjective sensation in the median or paramedian lumbar and/or sacral area radiating down to the leg of the involved nerve roots. Lately, it has been treated using epidural triamcinolone injection, but has limited measurement in pain scale and degree of disability. HMGB-1 has been considered to have a significant role in the chronicity of LBP. This study aims to determine changes in levels of the inflammatory biomarker HMGB-1 associated with clinical outcomes of CRLP after epidural triamcinolone injection.

Methods: This was an experimental study using a single-blind randomized control trial design, measuring changes in the degree of pain and disability using the pain scale and the Oswestry disability index (ODI) and analyzing HMGB-1 protein levels. Serum HMGB-1 was analyzed using the ELISA method. 57 participants were involved in the study and were divided randomly into 2 groups. Normalization of data distribution was tested using the Kolmogorov-Smirnov test; the outcome in each group were tested using the independent T-test and comparison of changes was tested using the Mann-Whitney U test; The correlation direction and strength between clinical outcomes and biomarker levels were tested using the ANOVA and multiple linear regression.

Results: The measurements of HMGB-1 protein levels before and after intervention in patients with CRLP pain showed a significant decrease in serum HMGB-1 on day 7 and was more significant in the intervention group. In comparative measurements of clinical outcomes measured by the pain scale and ODI before and after intervention, it was found that improvements in pain scales and disability scores were measured on the 7th day; this reduction was more significant in the intervention group.

Conclusion: There was an improvement in the clinical outcome after epidural triamcinolone administration was analyzed from serum HMGB-1 protein levels.

References

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How to Cite

Hammado, N., Akbar, M., Usman, M. A., Bukhari, A., Zainuddin, A. A., Emril, D. R., Hatta, M., Bintang, A. K., Tammasse, J., & Wuysang, A. D. (2023). Clinical outcomes of chronic radicular lumbosacral pain following epidural triamcinolone injection. Bali Medical Journal, 13(1), 342–349. https://doi.org/10.15562/bmj.v13i1.5021

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Nurussyariah Hammado
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Muhammad Akbar
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Muhammad Andry Usman
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Agussalim Bukhari
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Andi Alfian Zainuddin
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Dessy R Emril
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Mochammad Hatta
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Andi Kurnia Bintang
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Jumraini Tammasse
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Audry Devisanty Wuysang
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