- ESIs can be performed under conscious sedation in children and adolescents with good initial evidence for safety, though larger studies are needed to define relative risks.
- Based on our relatively low surgical rate compared to other pediatric series of herniated lumber discs, it is possible that including ESI into the treatment algorithm might ultimately facilitate improvement and lead to a decreased need for operative intervention.
- Median pain scores for both patient groups were significantly improved at all time points following the first ESI. At the last BCH follow-up visit, median pain score was significantly lower for those who had a discectomy compared to those who did not (see figure below).
- Further prospective studies may better define the role for these injections in the comprehensive management of pediatric spinal pain disorders.
Collaborating Research Groups
This study was conducted by members of Professor Berde’s laboratory within the Department of Anesthesiology, Perioperative, and Pain Medicine in collaboration with clinicians in Orthopedic Surgery, and Neurosurgery at Boston Children’s Hospital.
Related Publications
Kurgansky KE, Rodriguez ST, Kralj MS, Mooney JJ, Dinakar P, d’Hemecourt PA, HedequistDJ, Proctor MR, Berde CB. Epidural Steroid Injections for Radiculopathy and/or Back Pain in Children and Adolescents: A Retrospective Cohort Study with Prospective Follow-Up. Reg Anesth Pain Med. 2015 (in press).