Epidural steroid injection in spinal pain: a study on the NECA report

Kang, Hyun; Shin, Hwa Yong

Review

Spinal Pain

Anesthesia and Pain Medicine 2014;9(1):9-18.
Published online January 30, 2014.

Epidural steroid injection in spinal pain: a study on the NECA report

Department of Anesthesiology and Pain Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea. pain@cau.ac.kr

Received: 17 December 2013 • Revised: 29 December 2013

Abstract

Epidural steroid injection (ESI) may be the most widely used interventional procedure in the management of low back pain (LBP). Its use has been supported by more than 45 placebo-controlled studies and dozens of systematic reviews. However the report Pain Reduction Efficacy of Injection Therapy in Chronic LBP by the National Evidence-Based Collaborating Agency (NECA) in 2010 is seen to have mis-concluded that ESI is not effective in the management of chronic LBP. The NECA report contains various descriptive and statistical errors. In this review, we have attempted to correct the errors in the NECA report. We also inform the rationale and evidence of ESI by the review of recent meta-analysis and work to inspire a proper use of ESI in the Republic of Korea.

Key Words: Epidural steroid injection, Evidence-based practice, Low back pain