Predictors of outcome following an epidural steroid injection for disc-related sciatica: a Delphi consensus study.

Stynes, Siobhan; Foster, Nadine; O'Dowd, John; Ostelo, Raymond; Konstantinou, Kika

Abstract

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. 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. 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. Based on expert consensus, items that can be routinely collected in clinical practice were identified as potential predictors of outcomes following ESI. [Abstract copyright: © 2024. The Author(s).]

Citation

Stynes, S., Foster, N., O'Dowd, J., Ostelo, R., & Konstantinou, K. (in press). Predictors of outcome following an epidural steroid injection for disc-related sciatica: a Delphi consensus study. European Spine Journal, https://doi.org/10.1007/s00586-024-08342-2

• Journal Article Type: Article
• Acceptance Date: May 26, 2024
• Online Publication Date: Jun 7, 2024
• Deposit Date: Jun 25, 2024
• Journal: European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
• Print ISSN: 0940-6719
• Electronic ISSN: 1432-0932
• Publisher: Springer Verlag
• Peer Reviewed: Peer Reviewed
• DOI: https://doi.org/10.1007/s00586-024-08342-2
• Keywords: Prognostic factor, lumbar transforaminal epidural, Delphi procedure, Sciatica
• Public URL: https://keele-repository.worktribe.com/output/855691
• Publisher URL: https://link.springer.com/article/10.1007/s00586-024-08342-2