128. Comparison of Triamcinolone to Dexamethasone in the Treatment of Low Back and Leg Pain via Lumbar Transforaminal Epidural Steroid Injection

Background: Owing to the anatomical difference between the far lateral herniation of the lumbar disc (FHLD) and the intraspinal herniation of lumbar disc (iHLD), the outcome of transforaminal epidural steroid injections (TFESI) in patients with FHLD seems to be different from that in patients with iHLD. However, few studies have evaluated the efficacy of TFESI in FHLD. Objective: To evaluate and compare the efficacy of TFESI in FHLD and iHLD patients. Study Design: A retrospective design. Methods: There were 15 and 70 patients in the FHLD and iHLD groups, respectively. Patients received a fluoroscopically guided TFESI. Failure rates of TFESI were recorded, and questionnaires, including a visual analog scale (VAS) for leg pain and Oswestry Disability Index (ODI) were administered before the initial injection, at 2 weeks, 6 weeks, and 12 weeks after the injections. Results: There was no failure for TFESI in the iHLD group, while 9 patients had to undergo alternative blocks in the FHLD group due to lancinating leg pain when the needle was advanced for TFESI. In the iHLD group, there was a statistically significant improvement in the VAS and ODI score 12 weeks after injection. Considering only successful cases of the FHLD group, significant improvement in the VAS and ODI score was also demonstrated in the FHLD group 12 weeks after injection. Moreover, there was no statistically significant difference of the VAS and ODI between the both groups. Limitations: A relatively small numbers of cases were included in the FHLD group. Conclusion: The current study suggests that an alternative needle placement technique for TFESI appears to be necessary for FHLD patients. Key words: Far lateral herniation of lumbar disc, intraspinal herniation of lumbar disc, transforaminal epidural steroid injection, safe triangle, herniated lumbar disc, visual analog pain scale, Oswestry disability index, radiculopathy

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Study of role of caudal epidural steroid in management of low back pain in Malayalam patients

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20194812 ◽

2019 ◽

Vol 5 (6) ◽

pp. 1098

Author(s):

Jayakrishnan Rajasekharan

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Steroid Injection ◽

Epidural Steroid Injection ◽

Leg Pain ◽

Lumbar Region ◽

Low Back ◽

Visual Analogue Scale Scale ◽

Epidural Steroid ◽

Caudal Epidural

Background: 85 patients of different age groups were treated with caudal epidural steroid injection for the management of low back pain. As low back pain is quite common in adults.Methods: X-ray, MRI of the lumbar region was studied. Degree of the pain was assessed by VAS (visual analogue scale) scale, study of Lumbo-sacral joint was studied to know the causes of low back pain (LBP).Results: As per the MRI study classification LBP was classified as, 16 (16.3%) had Acute back pain without any cause, 14 (14.2%) had spondylolithesis having symptoms of claudication with low back pain. 26 (26.5%) had stenosis of Lumbar canal with symptoms of claudication 42 (42.8%) had disc degeneration with or without root radiation having complaint of back pain and leg pain. The improvement as per VAS scale was from 1 week to 3 months in the management of LBP.Conclusions: This pragmatic approach to various causes of low back pain managed with epidural steroid injection will be useful to orthopedic surgeon to treat such pain efficiently because back pain becomes common factor as age advances due to resorption or degenerative factors andcurvatures of vertebral column becomes less pronounceds.

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