Clinical Comparison of Effectiveness of Epidural Triamcinolone and Betamethasone in Discal Radiculalgia: A Prospective, Randomized Study

Abstract

Objectives: This study was planned to compare the efficacies of epidural betamethasone and triamcinolone injections in discal radiculalgia.Methods: Seventy patients complaining unilateral discal radiculalgia with acute discogenic pain were included in the study. The patients were randomly assigned to two groups. All patients received a single 20 ml epidural dose of steroid and 0.125 percent bupivacaine combination. The patients in group 1 and group 2 received betamethasone [14 mg] and triamcinolone [80 mg] by epidural injections, respectively. After the epidural steroid injection, the efficacy of treatment was assessed with visual analog scale [VAS], straight leg elevation test [0° = worst, 85° = best], and Oswestry Disability Index. The injection was repeated at the end of the second week, in case of partial improvement, and at the end of the sixth week if the recovery from pain was still incomplete. All patients were given amitriptyline [10 to 50 mg/day orally] for a period of six months.Results: There were 40 patients in group 1 and 30 patients in group 2. Significant improvement was observed in both groups regarding the results of VAS, straight leg elevation test, and the Oswestry Disability Index at the first week of the treatment. The VAS values at first, second, and sixth weeks were significantly lower in group 2 than in group 1 [P < 0.0001].Conclusion: Although, not statistically different in both groups at the final follow-up, we believe that triamcinolone is preferrable in an epidural steroid injection (ESI) procedure because of its short-term advantages.