Efficacy of caudal epidural injection of steroid versus steroid and calcitonin in patients with lumbosacral spinal stenosis: A randomized clinical trial
Bibliographic record
Abstract
Background: Lumbosacral spinal stenosis (LSS) is one of the most common causes of back pain and disability. Its treatment varies from surgical to conservative, and the indications for optimal management are not obviously defined. This study aimed to compare the efficacy of caudal epidural injection (CEI) of steroid with and without calcitonin in patients with LSS. Method: This is a randomized, double-blind clinical trial of 31 LSS patients diagnosed between January 1, 2017, to December 30, 2017, who were randomly allocated into two groups. Group A consisted of 17 patients who received C-arm (mobile fluoroscopy)- guided CEI of local anesthetic and steroid, and group B included 14 patients who received C-arm-guided CEI of 100 international unit calcitonin added to local anesthetic and steroid. Outcome measures included the visual analog scale (VAS) for pain during movement and walking distance, Oswestry disability index (ODI), and Quebec back pain disability scale (QBPDS) score, which were obtained from patients before the CEI as a baseline and after the second, fourth, and eighth weeks. Result: Before CEI, no significant differences were found between the two groups, neither in demographic characteristics nor in VAS, ODI, and QBPDS parameters. After CEI, VAS, ODI, and QBPDS improved from baseline through the second, fourth, and eighth weeks in both groups (p < 0.001) without any superiority between the two groups (p = 0.012, 0.078, and 0.019). Conclusion : CEI of steroid with and without adding calcitonin appears effective in the management of LSS. However, CEI of calcitonin does not appear to have any superiority when compared with steroid injection alone.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.004 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.005 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".