The Journal of Bone and Joint Surgery (American). 2005;87:458-459.
© 2005 The Journal of Bone and Joint Surgery, Inc.
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Epidural Steroid Injection Compared with Discectomy for the Treatment of Lumbar Disc Herniation

Robert F. McLain, MD1

1 The Cleveland Clinic Spine Institute
The Cleveland Clinic Foundation
Cleveland, OH 44195
mclainr@ccf.org

Letter to the Editor

Epidural Steroid Injection Compared with Discectomy for the Treatment of Lumbar Disc Herniation

Robert F. McLain, MD1

1 The Cleveland Clinic Spine Institute
The Cleveland Clinic Foundation
Cleveland, OH 44195
mclainr@ccf.org

The first 150 words of the full text of this article appear below.

To The Editor:

I would like to compliment Dr. Buttermann on his well-conceived and executed study entitled "Treatment of Lumbar Disc Herniation: Epidural Steroid Injection Compared with Discectomy" (2004;86:670-9). This study supports the commonly held notion that discectomy provides rapid pain relief and accelerates recovery but does not promise a quantifiably better result in the long run.

However, the open crossover design muddies the results a bit. Would a design that prevented crossover, at least for a defined period of many months to a year (a common clinical scenario in managed-care and Workers' Compensation systems), have provided the same results?

It is unclear from my reading whether the timetable for the crossover group was in step with that for the steroid group or the surgical group. If the values recorded for monthly intervals were measured from the time of the epidural steroid injection, then . . . [Full Text of this Article]

Glenn R. Buttermann, MD1

1 Midwest Spine Institute
1950 Curve Crest Boulevard
Stillwater, MN 55082


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Related articles in JBJS:

Treatment of Lumbar Disc Herniation: Epidural Steroid Injection Compared with Discectomy. A Prospective, Randomized Study
Glenn R. Buttermann
JBJS 2004 86: 670-679. [Abstract] [Full Text]