Epidural dexamethasone-21-palmitate for spinal stenosis-related pain: a retrospective cohort study using patient-reported outcome data

OBJECTIVE: Epidural steroid infiltration has been used for decades as symptomatic pain therapy. To record and evaluate treatment response to epidural steroid infiltration, patient-reported outcome data were collected from patients receiving interlaminar or transforaminal epidural steroid infiltrati...

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Main Authors: Anja Lehmann, Matthijs de Leeuw, Wilhelm Ruppen, Tobias Schneider
Format: Article
Language:English
Published: SMW supporting association (Trägerverein Swiss Medical Weekly SMW) 2025-04-01
Series:Swiss Medical Weekly
Online Access:https://smw.ch/index.php/smw/article/view/4100
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author Anja Lehmann
Matthijs de Leeuw
Wilhelm Ruppen
Tobias Schneider
author_facet Anja Lehmann
Matthijs de Leeuw
Wilhelm Ruppen
Tobias Schneider
author_sort Anja Lehmann
collection DOAJ
description OBJECTIVE: Epidural steroid infiltration has been used for decades as symptomatic pain therapy. To record and evaluate treatment response to epidural steroid infiltration, patient-reported outcome data were collected from patients receiving interlaminar or transforaminal epidural steroid infiltration with dexamethasone-21-palmitate (Lipotalon®). METHODS: This retrospective study included patient-reported outcome data from 212 patients who received treatment with translaminar or transforaminal epidural steroid infiltration at University Hospital Basel between July 2019 and April 2022. To evaluate pain and quality of life after treatment, the Numeric Rating Scale (NRS), Pain and Enjoyment of Life and General Activity (PEG) scale, European Quality of Life 5 Dimensions Questionnaire (EQ-5D-5L) and Oswestry Disability Index (ODI) were assessed prior to and at 7 days, one month and three months after treatment. RESULTS: There was a significant decrease in back pain on the NRS at 7 days and 3 months post-intervention compared to admission: 6.07 (SD 2.27) at admission, 4.52 (SD 2.26) at 7 days and 4.21 (SD 2.69) at 3 months (all p-values <0.001). Similarly, a significant decrease could be reported for leg pain: 5.59 (SD 2.72) at admission, 3.89 (SD 2.64) at 7 days and 3.58 (SD 2.84) at 3 months (all p-values <0.001). The mean PEG scale was 6.34 (SD 1.84) at admission, 4.52 (SD 2.15) at 7 days and 3.93 (SD 2.6) at 3 months (all p-values <0.001). The mean ODI score also improved significantly: 35.67 (SD 15.75) at admission, 28.24 (SD 16.11) at 7 days and 25.17 (SD 16.22) at 3 months (all p-values <0.002). The mean EQ-5D-5L score did not differ significantly during the observation period. CONCLUSIONS: Dexamethasone-21-palmitate may be a potential treatment alternative to traditional water-soluble steroids. However, further controlled trials are necessary to confirm the efficacy and safety of this treatment.
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spelling doaj-art-dfbb3f73ce06416fb2ce51ada685a42f2025-08-20T02:55:52ZengSMW supporting association (Trägerverein Swiss Medical Weekly SMW)Swiss Medical Weekly1424-39972025-04-01155410.57187/s.4100Epidural dexamethasone-21-palmitate for spinal stenosis-related pain: a retrospective cohort study using patient-reported outcome dataAnja Lehmann0Matthijs de Leeuw1Wilhelm Ruppen2Tobias Schneider3Department of Anesthesiology University Hospital Basel SwitzerlandDepartment of Anesthesiology University Hospital Basel SwitzerlandDepartment of Anesthesiology University Hospital Basel SwitzerlandPain Unit Department of Anesthesiology University Hospital Basel Switzerland OBJECTIVE: Epidural steroid infiltration has been used for decades as symptomatic pain therapy. To record and evaluate treatment response to epidural steroid infiltration, patient-reported outcome data were collected from patients receiving interlaminar or transforaminal epidural steroid infiltration with dexamethasone-21-palmitate (Lipotalon®). METHODS: This retrospective study included patient-reported outcome data from 212 patients who received treatment with translaminar or transforaminal epidural steroid infiltration at University Hospital Basel between July 2019 and April 2022. To evaluate pain and quality of life after treatment, the Numeric Rating Scale (NRS), Pain and Enjoyment of Life and General Activity (PEG) scale, European Quality of Life 5 Dimensions Questionnaire (EQ-5D-5L) and Oswestry Disability Index (ODI) were assessed prior to and at 7 days, one month and three months after treatment. RESULTS: There was a significant decrease in back pain on the NRS at 7 days and 3 months post-intervention compared to admission: 6.07 (SD 2.27) at admission, 4.52 (SD 2.26) at 7 days and 4.21 (SD 2.69) at 3 months (all p-values <0.001). Similarly, a significant decrease could be reported for leg pain: 5.59 (SD 2.72) at admission, 3.89 (SD 2.64) at 7 days and 3.58 (SD 2.84) at 3 months (all p-values <0.001). The mean PEG scale was 6.34 (SD 1.84) at admission, 4.52 (SD 2.15) at 7 days and 3.93 (SD 2.6) at 3 months (all p-values <0.001). The mean ODI score also improved significantly: 35.67 (SD 15.75) at admission, 28.24 (SD 16.11) at 7 days and 25.17 (SD 16.22) at 3 months (all p-values <0.002). The mean EQ-5D-5L score did not differ significantly during the observation period. CONCLUSIONS: Dexamethasone-21-palmitate may be a potential treatment alternative to traditional water-soluble steroids. However, further controlled trials are necessary to confirm the efficacy and safety of this treatment. https://smw.ch/index.php/smw/article/view/4100
spellingShingle Anja Lehmann
Matthijs de Leeuw
Wilhelm Ruppen
Tobias Schneider
Epidural dexamethasone-21-palmitate for spinal stenosis-related pain: a retrospective cohort study using patient-reported outcome data
Swiss Medical Weekly
title Epidural dexamethasone-21-palmitate for spinal stenosis-related pain: a retrospective cohort study using patient-reported outcome data
title_full Epidural dexamethasone-21-palmitate for spinal stenosis-related pain: a retrospective cohort study using patient-reported outcome data
title_fullStr Epidural dexamethasone-21-palmitate for spinal stenosis-related pain: a retrospective cohort study using patient-reported outcome data
title_full_unstemmed Epidural dexamethasone-21-palmitate for spinal stenosis-related pain: a retrospective cohort study using patient-reported outcome data
title_short Epidural dexamethasone-21-palmitate for spinal stenosis-related pain: a retrospective cohort study using patient-reported outcome data
title_sort epidural dexamethasone 21 palmitate for spinal stenosis related pain a retrospective cohort study using patient reported outcome data
url https://smw.ch/index.php/smw/article/view/4100
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