Are epidural steroid injections cost-effective for acute lumbosacral radicular syndrome?
A group of Danish researchers sought to find the answer and published their findings in Spine. In their pragmatic, randomized, controlled, single-blinded trial the researchers examined 63 patients with acute radiculopathy who either underwent "usual care" or one segmental epidural steroid injection containing 80 mg of triamcinolone in addition to usual care.
The researchers found:
1. Total average cost was $5,985 in the group that underwent the segmental epidural steroid injection and $6,943 in the control group. "The difference was mostly due to loss of productivity," the researchers concluded.
2. The point of estimated incremental cost-effectiveness ratio was -$990 with one-point diminishment on the numerical rating scale back pain score in one patient in the course of one year. The savings would be $990.
3. The confidence interval for bootstrapping was 95 percent, or -$6,068 to $1,289.
4. Without additional investment, the probability that epidural steroids are cost-effective is more than 80 percent.
5. The study authors recommend policy makers consider segmental epidural steroid injections as an additional treatment option. "The effect on pain and disability of epidural steroids in lumbosacral radicular syndrome is small but significant, and at lower costs with no reported complications or adverse events," concluded the study authors.