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Epidural Steroids Are Safe and Effective When Given Appropriately

Epidural Steroids Are Safe and Effective When Given Appropriately Abstract To the Editor. —We read with interest Nelson's1 most recent attack on the use of intraspinal steroids. It appears that Nelson is continuing his relentless crusade to banish the use of epidural steroids, a crusade based, as usual, more on an emotional than on a scientific basis.Initially it appears that the 19 references in his letter to the editor1 would strongly support his viewpoint. However, on closer evaluation, one realizes that 14 of those 19 references are Nelson's articles, many of which are simply letters to the editor or lectures to others rehashing the same material.The majority of the references discounting the use of intraspinal steroids address the intrathecal use. In addition, most of the complications encountered by Nelson, or quoted by him, occurred in patients with another significant neurologic disease process, ie, multiple sclerosis. And, when Nelson refers to Bernat's article2 regarding a complication from References 1. Nelson DA. Further warnings for Australia concerning intraspinal steroids . Arch Neurol . 1991;48:259.Crossref 2. Bernat JL, Sadowsky CH, Vincent FM, Nordgren RE, Margolis G. A complication of intrathecal administration of Depo-Medrol for multiple sclerosis . J Neurol Neurosurg Psychiatry . 1976;39:1124-1128.Crossref 3. Bernat JL. Intraspinal steroid therapy . Neurology . 1981;31:168-171.Crossref 4. Delaney TJ, Rowlingson JC, Carron H, Butler A. Epidural steroid effect on nerves and meninges . Anesth Analg . 1980;59:610-614. 5. Abram SE. Perceived dangers from intraspinal steroid injections . Arch Neurol . 1989;46:719-720.Crossref 6. Goebert HW, Jallo SJ, Gardner WJ, et al. Sciatica: treatment with epidural injections of procaine and hydrocortisone . Cleve Clin Q . 1960;27:191-197.Crossref 7. Swerdlow M, Sayle-Creer W. The use of extradural injections in the relief of lumbo-sciatic pain . Anaesthesia . 1970;25:128.Crossref 8. Winnie AP, Hartman JT, Meyers HL, et al. Pain clinic II: intradural and extradural corticosteroids for sciatica . Anesth Analg . 1972;51:990-999. 9. Dilke TFW, Burry HC, Grahame R. Extradural corticosteroid injection in management of lumbar nerve root compression . BMJ . 1973;2:635-637.Crossref 10. Benzon HT. Epidural steroid injections for low back pain and lumbosacral radiculopathy . Pain . 1986;24:277-295.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Neurology American Medical Association

Epidural Steroids Are Safe and Effective When Given Appropriately

Epidural Steroids Are Safe and Effective When Given Appropriately

Abstract

Abstract To the Editor. —We read with interest Nelson's1 most recent attack on the use of intraspinal steroids. It appears that Nelson is continuing his relentless crusade to banish the use of epidural steroids, a crusade based, as usual, more on an emotional than on a scientific basis.Initially it appears that the 19 references in his letter to the editor1 would strongly support his viewpoint. However, on closer evaluation, one realizes that 14 of those 19 references are...
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Publisher
American Medical Association
Copyright
Copyright © 1991 American Medical Association. All Rights Reserved.
ISSN
0003-9942
eISSN
1538-3687
DOI
10.1001/archneur.1991.00530220028013
Publisher site
See Article on Publisher Site

Abstract

Abstract To the Editor. —We read with interest Nelson's1 most recent attack on the use of intraspinal steroids. It appears that Nelson is continuing his relentless crusade to banish the use of epidural steroids, a crusade based, as usual, more on an emotional than on a scientific basis.Initially it appears that the 19 references in his letter to the editor1 would strongly support his viewpoint. However, on closer evaluation, one realizes that 14 of those 19 references are Nelson's articles, many of which are simply letters to the editor or lectures to others rehashing the same material.The majority of the references discounting the use of intraspinal steroids address the intrathecal use. In addition, most of the complications encountered by Nelson, or quoted by him, occurred in patients with another significant neurologic disease process, ie, multiple sclerosis. And, when Nelson refers to Bernat's article2 regarding a complication from References 1. Nelson DA. Further warnings for Australia concerning intraspinal steroids . Arch Neurol . 1991;48:259.Crossref 2. Bernat JL, Sadowsky CH, Vincent FM, Nordgren RE, Margolis G. A complication of intrathecal administration of Depo-Medrol for multiple sclerosis . J Neurol Neurosurg Psychiatry . 1976;39:1124-1128.Crossref 3. Bernat JL. Intraspinal steroid therapy . Neurology . 1981;31:168-171.Crossref 4. Delaney TJ, Rowlingson JC, Carron H, Butler A. Epidural steroid effect on nerves and meninges . Anesth Analg . 1980;59:610-614. 5. Abram SE. Perceived dangers from intraspinal steroid injections . Arch Neurol . 1989;46:719-720.Crossref 6. Goebert HW, Jallo SJ, Gardner WJ, et al. Sciatica: treatment with epidural injections of procaine and hydrocortisone . Cleve Clin Q . 1960;27:191-197.Crossref 7. Swerdlow M, Sayle-Creer W. The use of extradural injections in the relief of lumbo-sciatic pain . Anaesthesia . 1970;25:128.Crossref 8. Winnie AP, Hartman JT, Meyers HL, et al. Pain clinic II: intradural and extradural corticosteroids for sciatica . Anesth Analg . 1972;51:990-999. 9. Dilke TFW, Burry HC, Grahame R. Extradural corticosteroid injection in management of lumbar nerve root compression . BMJ . 1973;2:635-637.Crossref 10. Benzon HT. Epidural steroid injections for low back pain and lumbosacral radiculopathy . Pain . 1986;24:277-295.Crossref

Journal

Archives of NeurologyAmerican Medical Association

Published: Oct 1, 1991

References

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