J Korean Soc Spine Surg. 2005 Dec;12(4):310-315. Korean.
Published online Dec 31, 2005.
Copyright © 2005 Korean Society of Spine Surgery
Original Article

Efficacy of Epidural Steroid Injection in Lumbar Spinal Stenosis

Hee Seon Kim, M.D., Hak Jin Min, M.D., Ui Seoung Yoon, M.D., Jae Sung Seo, M.D., Yoon Jong Kim, M.D. and Seung Mok Jo, M.D.
    • Department of Orthopaedic Surgery, Seoul Medical Center, Seoul, Korea.

Abstract

Study Design

This is a retrospective study.

Objective

We wanted to evaluate the efficacy of epidural steroid injection (ESI) for treating lumbar spinal stenosis (LSS).

Summary of Literature Review

Treatment for lumbar spinal stenosis has generally consisted of some form of conservative treatment or surgery. Surgery may be contraindicated in many stenotic patients because of their significant comorbidities. Therefore, conservative management is necessary for those who cannot or do not want to undergo surgery.

Materials and Methods

From January 2002 to June 2003, we retrospectively analyzed 128 patients, 55 years or older, who received ESI (s). The average age of the men and women was 47 and 81, respectively. Their mean age was 76 (age range: 55~84). The injection materials were 2 ml methylprodnisolone acetate (40 mg/cc) in combination with 3 cc normal saline and 3 cc lidocaine. The follow up period was 12 months to 30 months. We measured the outcomes by the duration and amount of pain relief, the change in functional status and the rate of performing surgery; patient satisfaction was assessed by a 5-item questionnaire.

Result

Of the 128 participants, 31% reported more than 2 months of pain relief, 41% reported less than 2 months of pain relief and 27% reported no relief from the injection (s). Sixteen percent subsequently had surgery. Sixty-nine percent reported improvement in their functional abilities. Seventy-two percent were at least somewhat satisfied with ESI as a form of treatment.

Conclusion

ESI is a reasonable treatment for LSS as it provided one third of our patient population with sustained relief and more than half with sustained improvement in function.

Keywords
Spine; Spinal stenosis; Epidural steroid injection

Tables

Table 1
Outcome Assessment Instruments

Table 2
Univariate Analysis for Qeustion 1 (2>m/<2 m/None) (N=128)

Table 3
Multivariate Analysis* for Question 1 (>2 m/<2 m/None) (N=128)

Table 4
Univariate Analysis for Qeustion 2A (1=full/2=partial/3=none): Nonsurgery Patients Only (n=107)

Table 5
Multivariate Analysis* for Question 2A(1=Full/2=partial/3=none) (n=107)

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