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Review of injection Results by Dr Simon Harley, Spinal Physician

For more than 15 years Andrew Gilmour has referred patioents to Dr Simon Harley for injecting procedures of various types and for a range of conditions. This is Dr Harley's review of the results of his work.
Dr Simon Harley
Injection audit 28/5/10-28/5/11         
Steroid and anaesthetic injections

This is a follow up audit from last year. It enables monitoring of performance and comparison of outcomes.

As in last years audit I took all the consent forms for 1 year out of their folder and classified them into the different types of injections (see attached file). I had seen 130 new patients for injection (110 last year)and they had a total of 206 (192) injections (mean 1.58 (1.75) each) for 22 (19) different conditions.
I then looked through the computer records for each patient and classified the outcome into the following categories:

Worse: there were none who reported significant side effects or complications or that they felt their condition was worse after the injection.

No change: 20 (16) patients did not appear to have had any beneficial effect from the injection/course of injections = 15.4% (14.5%).

Improved: 62 (56) patients felt they were at least temporarily better but needed to continue physiotherapy or osteopathy treatment and the injection did not ‘close’ the episode of their problem = 47.7% (50.9%).

Better:  35 (29) patients reported themselves to be better after the injection(s) and the injection appeared to close the episode of their problem so that they did not need to continue osteopathy or physiotherapy treatment =26.9% (26.4%).

Not known: 11 (9) patients made no further contact with myself or other therapists at the practice (although they had all been specifically asked to return for follow up or at least telephone me).

Onward hospital referral: 9 (25) patients needed further follow up with investigation e.g. MRI or ultrasound scan or needed hospital treatment or a consultant follow up =6.92% (22.7%).

Results: for full results see table.  This audit shows consistency over two years and also correlates closely with a similar audit of my general practice patients. I conclude that these injection treatments are beneficial in over 75% of cases and there is a very low risk of adverse effects (no significant ones recorded over two years).

Closing Audit cycle: I intend to repeat the audit in 1 year


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