EFFECTIVENESS OF CAUDAL EPIDURAL STEROIDS IN DIFFERENT LUMBAR SPINE PATHOLOGIES

Dr. Vishal Bansal, Dr. Dhruv Lashkare, Dr. PV Siddhartha, Dr. Shubham Jain

Abstract


Background- Epidural steroids are being used for the management of PIVD and central lumbar canal stenosis through different routes. Most common routes to administer epidural steroids for such patients include interlaminar, caudal and transforaminal. Controversy persists regarding the efficacy of epidural steroids in reducing the pain associated with various lumbar spine pathologies as well as controversy exist regarding the preferred route of injection.

Aim- The present study was done to assess the effectiveness of caudal epidural steroid injection in patients with various lumbar spine pathologies.

Methodology- This was a retrospective study on patients diagnosed as lumbar canal stenosis and PIVD and who received caudal epidural steroid injections in the last 6 months. Data regarding presenting complaints before epidural caudal steroid injection and improvement following the injection was obtained from all the patients. Back pain and leg pain were assessed separately using Visual Analogue Scale (VAS) and functional disability was measured using Oswestry Disability Index (ODI) before the procedure (assessed from records) and at the time of enrollment in the study. Statistical analysis- Data compilation was done with the help of MS Excel and data analysis was done using IBM SPSS 20 software.

Results- The present study included a total of 60 patients i.e. 30 patients diagnosed with lumbar canal stenosis (central and lateral) and 30 patients with PIVD (including multiple level PIVD). The mean VAS score and ODI significantly improved in cases of PIVD and lumbar canal stenosis but they were more effective in treatment of central lumbar canal stenosis and multiple level PIVD (p<0.01) as compared to other groups.

Conclusion- Caudal epidural steroid injections are effective, easy and safe method which can be conducted as a day care procedure. They may reduce the need of subsequent surgeries. Caudal steroid injections were more effective in treatment of central lumbar canal stenosis as well as multiple level PIVD.

Keywords


PIVD, central lumbar canal stenosis, caudal epidural injections, ODI, VAS

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