JBJS | Epidural Steroid Injection Compared with Discectomy for the Treatment of Lumbar Disc Herniation

The Journal of Bone & Joint Surgery, Volume 87, Issue 2

Letters to the Editor | February 01, 2005

Epidural Steroid Injection Compared with Discectomy for the Treatment of Lumbar Disc Herniation

Robert F. McLain, MD¹

¹ The Cleveland Clinic Spine InstituteThe Cleveland Clinic FoundationCleveland, OH 44195mclainr@ccf.org

The Journal of Bone & Joint Surgery. 2005; 87:458-a-459

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To The Editor:I would like to compliment Dr. Buttermann on his well-conceived and executed study entitled "Treatment of Lumbar Disc Herniation: Epidural Steroid Injection Compared with Discectomy" (2004;86:670-9). This study supports the commonly held notion that discectomy provides rapid pain relief and accelerates recovery but does not promise a quantifiably better result in the long run.However, the open crossover design muddies the results a bit. Would a design that prevented crossover, at least for a defined period of many months to a year (a common clinical scenario in managed-care and Workers' Compensation systems), have provided the same results?

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Topics

diskectomy ; lumbar spine disc herniation ; epidural steroid injection

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These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.

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