Efficacy of Epidural Perineural Injections With Autologous Conditioned Serum for Lumbar Radicular Compression: An Investigator-Initiated, Prospective, Double-Blind, Reference-Controlled Study

  title={Efficacy of Epidural Perineural Injections With Autologous Conditioned Serum for Lumbar Radicular Compression: An Investigator-Initiated, Prospective, Double-Blind, Reference-Controlled Study},
  author={Cordelia Becker and Stefan Heidersdorf and Sascha Drewlo and Sonja Zirke de Rodriguez and J. Kr{\"a}mer and Roland Ernst Willburger},
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… 

Efficacy of Epidural Perineural Injection of Autologous Conditioned Serum in Unilateral Cervical Radiculopathy: A Pilot Study

ACS can be considered an equally good or better modality of nonoperative management in patients of unilateral cervical radiculopathy as MPS, and may be offered to affected patients before offering them surgery.

Comparison of interlaminar CT-guided epidural platelet-rich plasma versus steroid injection in patients with lumbar radicular pain

Platelet-rich plasma CT-guided epidural injections are similar to steroid for the treatment of lumbar radicular pain at 6 weeks post-procedure and could be a safer option.

Does Autologous Conditioned IL-1 Antagonist (ACS) Reduce Pain in Patients with OA or Lumbar Radiculopathy?

Results of the mentioned studies proved that ACS does decrease pain in patients with OA and LR; however, this pain reduction was not universally statistically significant and thus requiring further, more uniform trials.

Use of Autologous Serum in Treatment of Lumbar Radiculopathy Pain. Pilot Study.

  • Piotr Godek
  • Medicine
    Ortopedia, traumatologia, rehabilitacja
  • 2016
The Orthokine therapy conducted under ultrasound guidance may be an interesting option in the treatment of compression radiculopathy in the course of radicular compression due to a herniated disc and provides the rationale for studying larger groups of subjects in controlled studies over longer periods of time.

Autologous Conditioned Serum as a Novel Alternative Option in the Treatment of Unilateral Lumbar Radiculopathy: A Prospective Study

Autologous conditioned serum (ACS) can modify the disease course in addition to reducing pain, disability and improving general health.

The efficacy and safety of autologous conditioned serum (ACS) injections compared with betamethasone and placebo injections in the treatment of chronic shoulder joint pain due to supraspinatus tendinopathy: a prospective, randomized, double-blind, controlled study.

Compared with betamethasone, ACS therapy appears to be a more effective treatment than glucocorticoids and could enhance the quality of life in patients with chronic rotator cuff tendinopathy.

Intraarticular application of autologous conditioned serum (ACS) reduces bone tunnel widening after ACL reconstructive surgery in a randomized controlled trial

The intraarticular administration/injection of ACS results in decreased bone tunnel widening after ACL reconstructive surgery, and there were statistically significant differences in the WOMAC stiffness subscale after 1 year.

Epidural Injections for Lumbar Radiculopathy and Spinal Stenosis: A Comparative Systematic Review and Meta-Analysis.

Epidural corticosteroid injections for radiculopathy or spinal stenosis with sodium chloride solution or bupivacaine were shown to be ineffective, and meta-analysis showed a similar effectiveness for pain and function without non-inferiority of lidocaine compared to lidocane with steroid at 3 months and 12 months.

Autologous conditioned serum (Orthokine) injection for treatment of classical trigeminal neuralgia: results of a single-center case series

Orthokine injection led to consistent pain relief and reduced carbamazepine dosage in patients with trigeminal neuralgia, with acceptable safety.

Subcutaneous Injection of Adalimumab Trial compared with Control (SCIATiC): a randomised controlled trial of adalimumab injection compared with placebo for patients receiving physiotherapy treatment for sciatica.

A trial of biological therapy in patients with sciatica still needs to be done, but would require a clearer contracting process, qualitative research to ensure that patients would be willing to participate, and simpler recruitment methods.



The Treatment of Disc Herniation-Induced Sciatica With Infliximab: Results of a Randomized, Controlled, 3-Month Follow-up Study

The results of this randomized trial do not support the use of infliximab for lumbar radicular pain in patients with disc herniation-induced sciatica.

Lumbar epidural perineural injection: a new technique

The studies concluded that single-shot epidural perineural injection is effective in the treatment of lumbar radicular pain and is a “one drop only” therapy to the source of pain.

Epidural steroid injection for nerve root compression. A randomised, controlled trial.

There was a significant reduction in pain early on in those having an epidural steroid injection but no difference in the long term between the two groups, and the rate of subsequent operation in the groups was similar.

Neurophysiologic Changes in Lumbar Nerve Root Inflammation in the Rat After Treatment With Cytokine Inhibitors: Evidence for a Role of Interleukin‐1

The present results imply that interleukin‐1 is a causal factor in the model of experimental radiculitis used, and its specificity and apparent lack of side effects make interleucin‐ 1 receptor antagonist an attractive candidate treatment for the human disease.

[Efficacy of tumor necrosis factor-alpha blockade for severe sciatica?].

TNF-alpha have been proved to be the most important inflammatory cytokine and TNF- alpha modulators has been most effective in the treatment of animal models and two pilot studies realized on humans seem to confirm these experimental data.

The Oswestry Low Back Pain Disability Questionnaire a Two-Year Follow-Up of Spine Surgery Patients

  • R. Niskanen
  • Medicine
    Scandinavian journal of surgery : SJS : official organ for the Finnish Surgical Society and the Scandinavian Surgical Society
  • 2002
The graphs presented in this study may help the treating clinician to make conclusions on how his or her patients are doing on average after surgery, compared well with those of earlier studies.

The production of anti-inflammatory cytokines in whole blood by physico-chemical induction

The increased de novo production of anti-inflammatory cytokines by a direct physico-chemical induction of whole blood in the Orthokin system is feasible and offers an alternative, novel approach to treating mild to moderate OA and other orthopaedic conditions such as degenerative spine diseases.

Safety of tumour necrosis factor and interleukin-1 blocking agents in rheumatic diseases.

  • C. Botsios
  • Medicine, Biology
    Autoimmunity reviews
  • 2005

Pathogenesis of bone and cartilage destruction in rheumatoid arthritis.

Enhanced understanding of the mechanisms underlying the processes of joint destruction will allow more selective and specific application of therapeutic agents that target these proinflammatory cytokines and, thus, more effective management of patients with RA and other inflammatory disorders.

In vivo expression of inflammatory cytokine receptors in the joint compartments of patients with arthritis

The increased expression of TNFRp75 and IL-1RI in OA cartilage, compared to IA, in addition to the abundant local cytokine production, strengthens the hypothesis of autocrine/paracrine action by inflammatory cytokines in the pathogenesis of cartilage damage.