THE IMPACT OF LUMBAR EPIDURAL STEROID INJECTION ON NEUROPATHIC PAIN: A PROSPECTIVE OBSERVATIONAL STUDY.
Bibliographic record
Abstract
Objective: To study whether neuropathic or nociceptive pain was better improved after an epidural steroid injection. Study Design: Prospective study. Place and Duration of Study: Department of Orthopaedics, VYDEHI INSTITUTE OF MEDICAL SCIENCES AND RESEARCH CENTRE, BANGALORE, from Jan 2023 to Mar 2024. Background: Low back pain (LBP) can result from conditions such as disc herniation, spinal stenosis, or facet syndrome. It may manifest as either nociceptive pain or neuropathic pain (NP), with neuropathic pain being a signicant factor in chronic LBP. While lumbar epidural steroid injections (ESI) are recognized as an effective treatment for LBP, their effects on nociceptive and neuropathic pain have not been separately evaluated. This study aimed to determine whether ESI provides greater improvement in neuropathic or nociceptive pain. Methods: This prospective study classied patients based on their preprocedure painDETECT questionnaire (PD-Q) scores. A PD-Q score of ≤12 indicated nociceptive pain, while a score of ≥19 indicated neuropathic pain (NP). Patients received either a transforaminal (TF) or interlaminar (IL) epidural steroid injection (ESI). The PD-Q was completed by each patient both before the ESI (baseline) and four weeks afterward. Outcomes were evaluated one month after the ESI using the numerical rating scale (NRS), the short-form McGill Pain Questionnaire (MPQ), and the revised Oswestry Back Disability Index (ODI). Results:A total of 114 patients participated in the study, with 54 classied into the nociceptive pain group (PD-Q score ≤12) and 60 into the neuropathic pain group (PD-Q score ≥19). One month posttreatment, both groups demonstrated signicant reductions in their mean NRS scores. However, despite these improvements, there were no signicant differences in MPQ or ODI scores between the nociceptive and neuropathic pain groups. Following the procedure (TF-ESI or IL-ESI), PD-Q scores in the nociceptive group (n = 54) remained unchanged. In the neuropathic group (n = 41), 13 patients shifted to a PD-Q score <12, and 15 patients had PD-Q scores between 13 and 18. Conclusion: ESI proved effective for short-term relief of both nociceptive and neuropathic pain, suggesting its potential to address the neuropathic pain component in patients with low back pain.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
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 teacher head, 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".