Acute epidural haematoma following epidural steroid injection in a patient with spinal stenosis*

Background: Interlaminar epidural steroid injection (ESI) is a well-established intervention to improve radicular leg pain. However, few studies have demonstrated the prognostic factors for interlaminar ESI. Objective: To investigate the clinical effectiveness and prognostic indicators of parasagittal interlaminar ESI during a 2-week follow-up. Study Design: Prospective evaluation. Setting: An interventional pain management practice in South Korea. Methods: After Institutional Review Board approval, parasagittal interlaminar ESI under fluoroscopic guidance was performed in 55 patients with central spinal stenosis. The numerical rating scale (NRS) and the Oswestry Disability Index (ODI) (%) were used to evaluate clinical efficacy and prognostic indicators. To determine the prognostic indicators, treatment outcomes were classified as successful (decreased NRS ≥ 50%, decreased ODI ≥ 40%) and unsuccessful (decreased NRS < 50%, decreased ODI < 40%) results. Results: Parasagittal interlaminar ESI significantly improved the NRS and ODI (%) scores after 2 weeks compared to those measured pretreatment. Paresthesia provocation (P = 0.006) was a significant prognostic factor on the NRS, whereas the Beck Depression Inventory (BDI) score (P = 0.007), paresthesia provocation (P = 0.035), and epidurography finding (P = 0.038) were significant on the ODI (%) score between patients with successful and unsuccessful outcomes. Limitations: We included the method of parasagittal interlaminar ESI only, therefore, direct comparison with other techniques was not available. Conclusion: Parasagittal interlaminar ESI significantly improved the NRS and ODI (%) scores. Paresthesia provocation was a prognostic indicator on the NRS and ODI (%) scores, and BDI scores and epidurography findings were prognostic indicators for the ODI (%) score. Key words: Parasagittal interlaminar epidural steroid injection, spinal stenosis, radicular leg pain, prognostic indicator, paresthesia provocation, epidurography, Beck Depression Inventory

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Outcome measurements for post-epidural steroid injection pain relief in elderly patients with spinal stenosis: is the conservative approach an option?

Turkish Neurosurgery ◽

10.5137/1019-5149.jtn.29251-20.3 ◽

2020 ◽

Author(s):

Ali Muhittin Tasdogan ◽

Ebru Tarikci Kilic

Keyword(s):

Pain Relief ◽

Elderly Patients ◽

Spinal Stenosis ◽

Steroid Injection ◽

Epidural Steroid Injection ◽

Injection Pain ◽

Conservative Approach ◽

Outcome Measurements ◽

Epidural Steroid

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Comparison of Caudal Epidural Steroid Injection with Interlaminar Lumbar Inj. Epidural in Spinal Stenosis

10.53350/pjmhs211581877 ◽

2021 ◽

Vol 15 (8) ◽

pp. 1877-1879

Author(s):

Muhammad Akram ◽

Faheem Mubashir Farooqi ◽

Shumaila Jabbar

Keyword(s):

Spinal Stenosis ◽

Oswestry Disability Index ◽

Steroid Injection ◽

Epidural Steroid Injection ◽

Steroid Injections ◽

Epidural Steroid Injections ◽

Group I ◽

Group Ii ◽

Epidural Steroid ◽

Caudal Epidural

Background: Lumbar spinal stenosis is a condition caused by narrowing of spinal canal. Steroid injection either lumbar or caudal can improve the functional outcome and low back pain. Aim: To compare the outcome of caudal epidural steroid injection with lumbar epidural steroid injection in treating spinal stenosis in patients suffering from sciatica. Methods: In this prospective study 338 patients having low backache due to spinal stenosis with sciatica were included from June 2013 to December 2014. Patients were randomly divided into two groups. Group I and II. Patients in Group I (160 patients) received caudal epidural steroid injections while the patients in Group II (178 patients) received lumbar epidural steroid injections. Visual analog scale (VAS) and Oswestry Disability Index (ODI) was used to assess outcome of the Caudal and Lumbar steroid injections and was measured at 2 weeks, at 3months, and improvement was declared if VAS decrease ≥50% of baseline and Oswestry disability index decrease ≥40% at 3 months. Results: In group I, there were 70(43.75%) males and 90(56.25%) females, while in group II there were 98(55.1%) males and 80(44.9%) females. The mean age of the patients in group I was 46.46±10.37 (18-75 years) years and was 43.77±15.27 years (18-75 years) in group II (P=0.0619). The change in pain score (>50%) was observed in 159 (89.33%) in group II compared with 121 (75%) in group I (P=0.0008). Conclusion: Lumbar epidural of steroids injections are more effective then caudal epidural injection of steroids in treating spinal stenosis. MeSH words: Caudal epidural, Lumbar epidural, Sciatica

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