scholarly journals Comparison of Three Doses of Epidural Steroid Injection with Single Dose of Epidural Steroid Injection for Lumbar Radicular pain in Spinal Stenosis Patients

2016 ◽  
Vol 6 (1_suppl) ◽  
pp. s-0036-1582855-s-0036-1582855
Author(s):  
Saeed Ahmad ◽  
Amer Aziz ◽  
Ijaz Ahmed ◽  
Shahzad Javed ◽  
Naeem Ahmed ◽  
...  
Keyword(s):  
Single Dose ◽  
Spinal Stenosis ◽  
Steroid Injection ◽  
Radicular Pain ◽  
Epidural Steroid Injection ◽  
Lumbar Radicular Pain ◽  
Epidural Steroid

scholarly journals Outcome of Transforaminal Epidural Steroid Injection According to the Severity of Lumbar Foraminal Spinal Stenosis

2018 ◽  
Vol 1 (21;1) ◽  
pp. 67-72 ◽  
Author(s):  
Min Cheol Chang, MD Chang
Keyword(s):  
Spinal Stenosis ◽  
Rating Scale ◽  
Steroid Injection ◽  
Radicular Pain ◽  
Epidural Steroid Injection ◽  
University Hospital ◽  
Group A ◽  
Transforaminal Epidural Steroid Injection ◽  
Lumbar Radicular Pain ◽  
Epidural Steroid

Background: Lumbar foraminal spinal stenosis (LFSS) is a common cause of radicular pain in the lower extremities. Transforaminal epidural steroid injection (TFESI) is being used widely for controlling radicular pain induced by LFSS. The efficacy of TFESI has been demonstrated in previous studies. However, no study has evaluated the outcome of TFESI according to the severity of LFSS. Objective: In this study, we evaluated the outcome of TFESI in patients with chronic lumbar radicular pain due to LFSS according to the severity of LFSS by using magnetic resonance imaging (MRI). Study Design: A prospective observational study. Setting: A university hospital. Methods: Sixty patients with chronic lumbar radicular pain due to LFSS were included in this prospective study and received TFESI at our university hospital. Three patients were lost to followup. On the basis of sagittal lumbar MRI findings, we assigned patients with mild to moderate LFSS to group A (n = 31) and those with severe LFSS to group B (n = 26). Pain intensity was evaluated using a numeric rating scale (NRS) before treatment and at 1, 2, and 3 months after treatment. Results: Compared to pretreatment NRS scores, a significant decrease in NRS scores was observed in patients in both groups at 1, 2, and 3 months after treatment (P = 0.000). However, reductions in the NRS scores over time were significantly larger in group A (P = 0.023). Three months after treatment, 27 patients (87.1%) in group A and 11 patients (42.3%) in group B reported successful pain relief (pain relief of ≥ 50%). Limitations: This study had a small number of patients. Conclusions: After TFESI, chronic lumbar radicular pain was significantly reduced regardless of the severity of LFSS, and the effects of TFESI were sustained for at least 3 months after treatment. However, the outcome of TFESI was superior in the group with a mild to moderate degree of LFSS, compared to the group with a severe degree of LFSS. We believe that our study provides useful information for establishing a treatment plan for radicular pain due to LFSS. Key words: Lumbar foraminal spinal stenosis, transforaminal epidural steroid injection, disease severity, magnetic resonance imaging, numeric rating scale, corticosteroids

scholarly journals SPINAL STENOSIS

2018 ◽  
Vol 25 (09) ◽  
pp. 1323-1327
Author(s):  
Saeed Ahmad ◽  
Haseeb Hussain ◽  
Ashfaq Ahmed ◽  
Rizwan Akram ◽  
Ijaz Ahmed ◽  
...  
Keyword(s):  
Single Dose ◽  
Spinal Stenosis ◽  
Local Anesthesia ◽  
Steroid Injection ◽  
Epidural Steroid Injection ◽  
Lower Back ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Epidural Steroid

Introduction: Spinal stenosis causing lower back pain and radiculopathy andit is the most common cause of patient admission at Spine centre as compared to other spinepathologies. Most common complaint in the Spine outpatient department or hospital admissionsDifferent modalities have been applied with time for its management. Among them Epiduralsteroid injection is also. Objectives: “To Compare three doses of epidural steroid injection withsingle dose of epidural steroid injection for Lumbar Radicular pain in spinal stenosis patients.”Study Design: Prospective study. Setting: Ghurki Trust Teaching Hospital, Lahore, Pakistan.Period: Jan 2016 to Dec 2016. Materials and Methods: 95 patients with lumbar radicular paindue to spinal stenosis were randomly allocated into 2 groups. In Group A, 42 patients were given120 mg of Depo-medrol (40 mg per day for 3 days) along with local anesthesia and in group B,43 patients were given 40 mg of Depo-medrol with local anesthesia as a single dose. Both GroupA and Group B were matched in terms of age and gender. On visual analogue scoring, pain wasassessed after 2 weeks, 3 months and 6 months. Results: In Group A (3 doses of depomedrol)VAS improvement at 2 weeks, 3 months and 6 months were more than group B (single dose ofdepomedrol) which was statistically significant (p < 0.05). There were no major complicationslike epidural hematoma or abscess formation in both groups. The overall minor complicationslike flushing, transient hyperglycemia and headache due to CSF hypotension were more inGroup A than Group B but statistics shows no significant difference. All the adverse eventsresolved within few days without any significant morbidity and subsequent hospitalizations.Conclusion: Epidural steroid injection is excellent modality in the treatment of lower back painwith radiculopathy. Moreover 3 doses have greater effect in relieving pain as compared to singledose. There is no increase risk of complications by increasing dose.

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