TY - JOUR
T1 - Predictors of outcome following an epidural steroid injection for disc-related sciatica
T2 - a Delphi consensus study
AU - Stynes, Siobhan
AU - Foster, Nadine
AU - O’ Dowd, John
AU - Ostelo, Raymond
AU - Konstantinou, Kika
N1 - Publisher Copyright:
© The Author(s) 2024.
PY - 2024/11
Y1 - 2024/11
N2 - Purpose: Trial data shows modest reductions in leg pain, disability and surgery avoidance following epidural steroid injections (ESI) for severe sciatica. Despite their common use, there is no clear evidence about which patients are more likely to benefit from ESI. The aim of this study was to generate consensus on potential predictors of outcome following ESI for disc-related sciatica. Methods: A list of potential predictors of outcome was generated during a consensus meeting of seven experts. The items were subsequently presented in a two round on-line Delphi study to generate consensus among experts on which items are potential predictors of outcome. Consensus was defined as 70% agreement among participants. Results: Sixty-one items were generated during the consensus meeting. Of ninety experts invited to participate in the on-line Delphi study, 44 (48%) and 33 (73%) took part in rounds one and two respectively. Twenty-eight additional items suggested by participants in round one were included in round two. Overall, 14 items reached consensus reflecting domains of health, medication use, pain intensity, psychosocial factors, imaging findings and type of injection. Conclusion: Based on expert consensus, items that can be routinely collected in clinical practice were identified as potential predictors of outcomes following ESI.
AB - Purpose: Trial data shows modest reductions in leg pain, disability and surgery avoidance following epidural steroid injections (ESI) for severe sciatica. Despite their common use, there is no clear evidence about which patients are more likely to benefit from ESI. The aim of this study was to generate consensus on potential predictors of outcome following ESI for disc-related sciatica. Methods: A list of potential predictors of outcome was generated during a consensus meeting of seven experts. The items were subsequently presented in a two round on-line Delphi study to generate consensus among experts on which items are potential predictors of outcome. Consensus was defined as 70% agreement among participants. Results: Sixty-one items were generated during the consensus meeting. Of ninety experts invited to participate in the on-line Delphi study, 44 (48%) and 33 (73%) took part in rounds one and two respectively. Twenty-eight additional items suggested by participants in round one were included in round two. Overall, 14 items reached consensus reflecting domains of health, medication use, pain intensity, psychosocial factors, imaging findings and type of injection. Conclusion: Based on expert consensus, items that can be routinely collected in clinical practice were identified as potential predictors of outcomes following ESI.
KW - Delphi procedure
KW - Prognostic factor, lumbar transforaminal epidural
KW - Sciatica
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U2 - 10.1007/s00586-024-08342-2
DO - 10.1007/s00586-024-08342-2
M3 - Article
AN - SCOPUS:85195290613
SN - 0940-6719
VL - 33
SP - 4235
EP - 4242
JO - European Spine Journal
JF - European Spine Journal
IS - 11
ER -