Effectiveness of Bilateral Transforaminal Epidural Steroid Injections in Degenerative Lumbar Spinal Stenosis Patients With Neurogenic Claudication: A Case Series

PM&R ◽  
2016 ◽  
Vol 9 (1) ◽  
pp. 26-31 ◽  
Author(s):  
Mustafa Farooque ◽  
Michele M. Salzman ◽  
Zhan Ye
Keyword(s):  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Case Series ◽  
Neurogenic Claudication ◽  
Steroid Injections ◽  
Degenerative Lumbar Spinal Stenosis ◽  
Epidural Steroid Injections ◽  
Lumbar Spinal ◽  
Epidural Steroid

scholarly journals Fluoroscopically Guided Caudal Epidural Steroid Injections in Degenerative Lumbar Spinal Stenosis

2007 ◽  
Vol 4;10 (7;4) ◽  
pp. 558-558
Author(s):  
Kenneth P. Botwin
Keyword(s):  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Radicular Pain ◽  
Satisfaction Scale ◽  
Steroid Injections ◽  
Degenerative Lumbar Spinal Stenosis ◽  
Epidural Steroid Injections ◽  
Lumbar Spinal ◽  
Epidural Steroid ◽  
Caudal Epidural

Background: Caudal epidural steroid injections are commonly utilized to help reduce radicular pain in lumbar spinal stenosis. There have been studies done to evaluate the effectiveness of this procedure non-fluoroscopically guided. Search revealed no prospective studies evaluating the effectiveness of fluoroscopically guided caudal epidural injections on patients with bilateral radicular pain from degenerative lumbar spinal stenosis. Objective: To evaluate the therapeutic benefit of fluoroscopically guided caudal epidural steroid injections in the treatment of bilateral radicular pain from symptomatic Degenerative Lumbar Spinal Stenosis (DLSS). Design: This prospective cohort study was performed on 34 patients with bilateral radicular pain from lumbar spinal stenosis who received fluoroscopically guided caudal epidural injections at a multidisciplinary spine center as they did not improve with conservative care. The patients’ degenerative lumbar spinal stenosis was confirmed by magnetic resonance imaging and classified as mild, moderate, or severe. The patients were evaluated by an independent observer and completed questionnaires, prior to initial injection, at 6 weeks, 6 months and 12 months after the injections. Outcome Measures: Visual analog scale, patient satisfaction scale, standing/walking tolerance scale and Oswestry low back pain disability questionnaire. Results: A total of 34 patients met our inclusion criteria and were followed at 6 weeks, 6 months, and 12 months. Sixty-five percent of patients at 6 weeks, 62% at 6 months, and 54% at 12 months had a successful outcome, reporting at least a >50% reduction between pre-injection and post injection visual analog pain scores. Fifty nine percent of patients had an improved walking tolerance at 6 weeks (P <0.0001), 56% at 6 months (P <0.0001), and 51% at 12 months (P=0.0005). Fifty percent of patients had an improved standing tolerance at 6 weeks (P= 0.0002), 54% at 6 months (P < 0.0001), and 51% at 12 months (P=0.0005). The patient satisfaction scale revealed 64% of patients felt completely or somewhat better at 6 weeks, 59% at 6 months and 52% at 12 months. Owestry low back pain disability questionnaire scores showed statistically significant improvement from initial scores to 6 weeks (P < 0.0001), initial to 6 months (P= 0.0095), and initial to 12 months (P=0.00015). The outcome was statistically significant even in severe stenotic patients when comparing initial mean scores to 12 month mean scores in standing tolerance (P =0.2956), walking tolerance (P=0.0250), and VAS (P= 0.0199). Conclusion: Fluoroscopically guided caudal epidural steroid injections may help reduce bilateral radicular pain and improve standing and walking tolerance in patients with DLSS. Key words: Injections, epidural radiculopathy, lumbar spinal stenosis, rehabilitation

Effectiveness of Physical Therapy and Epidural Steroid Injections in Lumbar Spinal Stenosis

Spine ◽  
2009 ◽  
Vol 34 (10) ◽  
pp. 985-989 ◽  
Author(s):  
Zarife Koc ◽  
Suheda Ozcakir ◽  
Koncuy Sivrioglu ◽  
Alp Gurbet ◽  
Selcuk Kucukoglu
Keyword(s):  
Physical Therapy ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Steroid Injections ◽  
Epidural Steroid Injections ◽  
Lumbar Spinal ◽  
Epidural Steroid

80. The Use of Lumbar Epidural Steroid Injections in Lumbar Spinal Stenosis (LSS)

2008 ◽  
Vol 33 (Suppl 1) ◽  
pp. e193.2-e193
Author(s):  
J. Geelen ◽  
C. Vandenbosch ◽  
M. Puylaert ◽  
P. Vanelderen ◽  
P. De Vooght ◽  
...  
Keyword(s):  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Steroid Injections ◽  
Epidural Steroid Injections ◽  
Lumbar Spinal ◽  
Epidural Steroid

Treatment of lumbar spinal stenosis with epidural steroid injections: a retrospective outcome study

2004 ◽  
Vol 85 (3) ◽  
pp. 479-484 ◽  
Author(s):  
Elva G Delport ◽  
Anthony R Cucuzzella ◽  
Julie K Marley ◽  
Christine M Pruitt ◽  
J.Rush Fisher
Keyword(s):  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Outcome Study ◽  
Steroid Injections ◽  
Epidural Steroid Injections ◽  
Lumbar Spinal ◽  
Epidural Steroid

Lumbar Neurogenic Claudication

2018 ◽  
Author(s):  
Raj J. Gala ◽  
James Yue
Keyword(s):  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
The Elderly ◽  
Clinical Syndrome ◽  
Neurogenic Claudication ◽  
Epidural Steroid Injections ◽  
Magnetic Resonance Imaging Mri ◽  
Asymptomatic Individuals ◽  
Lumbar Spinal ◽  
Epidural Steroid

Lumbar neurogenic claudication, sometimes referred to as pseudoclaudication, is the clinical syndrome of back pain radiating down one or both legs during ambulation. Classically, the symptoms abate with forward flexion of the lumbar spine and worsen with extension. The condition arises from lumbar spinal stenosis, which is common in the elderly population. Many asymptomatic individuals have lumbar spinal stenosis seen on magnetic resonance imaging (MRI), so this syndrome is a clinical diagnosis. The majority of patients have favorable responses with conservative treatment, which includes physical therapy, bracing, medications, and epidural steroid injections. Patients who do not improve may go on to have surgery. Spinal stenosis has become one of the most common reasons to undergo lumbar spinal surgery in patients older than 65 years of age.

The Use of Lumbar Epidural Steroid Injections in Lumbar Spinal Stenosis (LSS)

2008 ◽  
Vol 33 (Sup 1) ◽  
pp. e193
Author(s):  
J. Geelen ◽  
C. Vandenbosch ◽  
M. Puylaert ◽  
P. Vanelderen ◽  
P. De Vooght ◽  
...  
Keyword(s):  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Steroid Injections ◽  
Epidural Steroid Injections ◽  
Lumbar Spinal ◽  
Epidural Steroid
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