Epidural caudal steroid injection in low backache and lumbar radiculopathy at tertiary care centre
2021
Background: Most of the lumbosacral radiculopathies are caused by irritation of spinal nerve roots associated with lower back and leg pain. Most common causes for spinal root irritation are intervertebral disc herniation and spinal canal stenosis, other causes include spondylolisthesis, spondylosis, thickening of ligamentum flavum, scoliosis etc. Lumbar radiculopathy frequently treated by epidural corticosteroid injections. Common route for administering epidural steroid injections are interlaminar, transforaminal and caudal. But there are concerns due to rare major neurologic complications after this treatment. Therefore this literature focuses on caudal route of epidural steroid injections.
Objective: To know the benefits of caudal epidural steroid injection in lumbar radiculopathy and low backache by analyzing clinical and functional outcome.
Results: Out of 35 patients, in 28 patients (80%) low backache and radiating pain subsided after 3 days. But 7 patients (20%) get partial relief or having persistent complaints after 3 days, administered 2epidural steroid injection after a month. After one month 32 patients (91%) do not complain of pain but 3 patients (9%) tend to have some back pain which eventually improved on two to three months of regular physiotherapy and postural correction exercises.
Conclusion: Caudal epidural steroid injections are safe, quick and effective. It can be performed on OPD basis, has considerably fewer side effects than surgery. Therefore injections can help to increase function while avoiding surgery and long term use of analgesics.
Keywords: Epidural injection, Caudal route, Steroids, Low backache.
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