PMID- 17762286
OWN - NLM
STAT- MEDLINE
DCOM- 20071002
LR  - 20131121
IS  - 1528-1159 (Electronic)
IS  - 0362-2436 (Linking)
VI  - 32
IP  - 17
DP  - 2007 Aug 1
TI  - Efficacy of epidural perineural injections with autologous conditioned serum for 
      lumbar radicular compression: an investigator-initiated, prospective, 
      double-blind, reference-controlled study.
PG  - 1803-8
AB  - STUDY DESIGN: Prospective, double-blind, reference-controlled, 
      investigator-initiated, single center. OBJECTIVE: To evaluate the efficacy of 
      Autologous Conditioned Serum (ACS; Orthokine) for the treatment of lumbar 
      radicular compression in comparison to triamcinolone. SUMMARY OF BACKGROUND DATA: 
      Evidence from animal studies indicates that cytokines such as interleukin-1 play 
      a decisive role in the pathophysiology of lumbar radiculopathy. ACS is enriched 
      in the interleukin-1 receptor antagonist and other anti-inflammatory cytokines. 
      METHODS: Thirty-two patients were treated by epidural perineural injections with 
      ACS; 27 patients were treated with 5 mg triamcinolone and 25 patients with 10 mg 
      triamcinolone. Treatment was applied once per week for 3 consecutive weeks and 
      followed for 6 months. The Visual Analogue Scale (VAS) of low back pain was the 
      primary outcome measure. The Oswestry Disability Index (ODI) was the secondary 
      endpoint of the study. All statistical analyses were performed in an exploratory 
      manner using SAS for Windows, version 8.2, on a personal computer. Descriptive 
      statistics were calculated for the VAS and ODI by treatment group and time point. 
      The data were submitted to a repeated-measurements analysis of variance with 
      effects on treatment group, time, and treatment group-by-time interaction. 
      RESULTS: Patients with lumbar back pain who were treated with ACS or the 2 
      triamcinolone concentrations showed a clinically remarkable and statistically 
      significant reduction in pain and disability, as measured by patient administered 
      outcome measurements. From Week 12 to the final evaluation at Week 22, injections 
      with ACS showed a consistent pattern of superiority over both triamcinolone 
      groups with regard to the VAS score for pain, but statistical significance was 
      observed only at Week 22 in direct comparison to the triamcinolone 5 group. 
      However, there was no statistically significant difference between the 2 
      triamcinolone dosages during the 6 months of the study. CONCLUSION: ACS is an 
      encouraging treatment option for patients with unilateral lumbar radicular 
      compression. The decrease in pain was pronounced, clinically remarkable, and 
      potentially superior to steroid injection.
FAU - Becker, Cordelia
AU  - Becker C
AD  - Department of Orthopaedic Surgery, St. Josef-Hospital, University of Bochum, 
      Bochum, Germany. Cordelia.Becker@elis-stiftung.de
FAU - Heidersdorf, Stefan
AU  - Heidersdorf S
FAU - Drewlo, Sascha
AU  - Drewlo S
FAU - de Rodriguez, Sonja Zirke
AU  - de Rodriguez SZ
FAU - Kramer, Juergen
AU  - Kramer J
FAU - Willburger, Roland Ernst
AU  - Willburger RE
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - United States
TA  - Spine (Phila Pa 1976)
JT  - Spine
JID - 7610646
RN  - 0 (Anti-Inflammatory Agents)
RN  - 0 (Biological Products)
RN  - 0 (Interleukin 1 Receptor Antagonist Protein)
RN  - 1ZK20VI6TY (Triamcinolone)
SB  - IM
EIN - Spine. 2007 Nov 15;32(24):table of contents. Dosage error in article text
CIN - Spine (Phila Pa 1976). 2008 Mar 1;33(5):576. PMID: 18317206
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Anti-Inflammatory Agents/*administration & dosage
MH  - Biological Products/*administration & dosage
MH  - Disability Evaluation
MH  - Double-Blind Method
MH  - Female
MH  - Humans
MH  - Injections, Epidural
MH  - Interleukin 1 Receptor Antagonist Protein/*administration & dosage/biosynthesis
MH  - Low Back Pain/drug therapy/*etiology/therapy
MH  - Male
MH  - Middle Aged
MH  - Pain Measurement
MH  - Prospective Studies
MH  - Radiculopathy/complications/drug therapy/*therapy
MH  - Serum/*metabolism
MH  - Time Factors
MH  - Treatment Outcome
MH  - Triamcinolone/*administration & dosage
EDAT- 2007/09/01 09:00
MHDA- 2007/10/03 09:00
CRDT- 2007/09/01 09:00
PHST- 2007/09/01 09:00 [pubmed]
PHST- 2007/10/03 09:00 [medline]
PHST- 2007/09/01 09:00 [entrez]
AID - 00007632-200708010-00002 [pii]
AID - 10.1097/BRS.0b013e3181076514 [doi]
PST - ppublish
SO  - Spine (Phila Pa 1976). 2007 Aug 1;32(17):1803-8. doi: 
      10.1097/BRS.0b013e3181076514.