Discal Sciatica
Conditions
Keywords
Epidural infiltration of Corticoids, L3-L4 stage, On contact of disco radicular conflict, Scan control
Brief summary
In discal sciatica, after failure of medical treatment, the investigators propose frequently a spinal infiltration of corticoids the most closer of disco-radicular conflict. Recently, some cases of paraplegia during lumbar foraminal infiltrations have induce a reduction of indications of this type of infiltration. An alternative would be to propose a lateral epidural infiltration on contact with conflict.The objective of this study is to compare, in 112 patients with a less than 6 months discal sciatica, the efficacy on pain of a non target posterior epidural space infiltration of corticoids done at L3-L4 stage on scan control versus an epidural infiltration of the same corticoid done in lateral on contact of disco radicular conflict on scan control.
Interventions
PROCEDURENon target epidural infiltration done at L3-L4 stage
For patients included in control arm, a non target posterior epidural space infiltration of corticoids will be done at L3-L4 stage on scan control
PROCEDUREEpidural infiltration on contact of disco radicular conflict
For patients included in experimental arm, an epidural infiltration of corticoids will be done in lateral on contact of disco radicular conflict on scan control.
Sponsors
University Hospital, Montpellier
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Investigator)
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Informed consent * Aged from 18 to 65 years * Affiliated or benefit from an insurance regimen * Patient with a sciatic answering to the definition * Discal sciatica more than 15 days and less than 6 months * Discal hernia (scan or RMI) * Negative BHCG and normal coagulation parameters
Exclusion criteria
* History of lumbar surgery * Spinal infiltration of corticoids in 30 days before inclusion * Iode allergy * Anticoagulation therapy, unbalanced type 2 diabetes, instable HTA * Motor loss \< 4 (muscular testing) * Sphincter disorder (cauda equida syndrome)
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Pain evolution on analogic visual scale (EVA) ay Day 30 | at Day 30 after infiltration |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Pain evolution on analogic visual scal (EVA) at month 3 | at month 3 after infiltration | — |
| Pain evolution on analogic visual scal (EVA) at month 6 | at month 6 after infiltration | — |
| Pain evolution on analogic visual scal (EVA) at month 12 | at month 12 after infiltration | — |
| drug consumption at day 7 | at day 7 after infiltration | — |
| drug consumption at month 3 | at month 3 after infiltration | — |
| drug consumption at month 6 | at month 6 after infiltration | — |
| drug consumption at month 12 | at month 12 after infiltration | — |
| functional handicap at Day 7 | at day 7 after infiltration | functional handicap is assessed by auto-questionnary |
| functional handicap at month 3 | at month 3 after infiltration | functional handicap is assessed by auto-questionnary |
| Pain evolution on analogic visual scal (EVA) at Day 7 | at day 7 after infiltration | — |
| functional handicap at month 12 | at month 12 after infiltration | functional handicap is assessed by auto-questionnary |
| professional activity recovery at Day 7 | at day 7 after infiltration | professional activity recovery is assessed by patient's interrogation: if recovery, conditions of recovery, date of recovery. If not recovery, for why? |
| professional activity recovery at month 3 | at month 3 after infiltration | professional activity recovery is assessed by patient's interrogation: if recovery, conditions of recovery, date of recovery. If not recovery, for why? |
| professional activity recovery at month 6 | at month 6 after infiltration | professional activity recovery is assessed by patient's interrogation: if recovery, conditions of recovery, date of recovery. If not recovery, for why? |
| professional activity recovery at month 12 | at month 12 after infiltration | professional activity recovery is assessed by patient's interrogation: if recovery, conditions of recovery, date of recovery. If not recovery, for why? |
| new epidural infiltration or surgery of discal hernia at Day 7 | at day 7 after infiltration | — |
| new epidural infiltration or surgery of discal hernia at month 3 | at month 3 after infiltration | — |
| new epidural infiltration or surgery of discal hernia at month 6 | at month 6 after infiltration | — |
| new epidural infiltration or surgery of discal hernia at month 12 | at month 12 after infiltration | — |
| functional handicap at month 6 | at month 6 after infiltration | functional handicap is assessed by auto-questionnary |
Countries
France
Contacts
Primary ContactEric ET THOMAS, MD
Outcome results
None listed