Original research article Prospective observational study to evaluate the role of caudal epidural steroid injections in the management of chronic-LBP
European Journal of Molecular & Clinical Medicine,
2020, Volume 7, Issue 11, Pages 8071-8077
AbstractAim: to find the role of caudal epidural steroid injections in the management of chronic low backache.
Material and methods: This prospective observational study was carried out in the Department of Orthopaedics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pardesh, India from March 2016 to October 2017. 60 Patients more than 20 years and less than 65 years with chronic function- limiting LBP of at least 6 months duration not responding to oral medications, short wave diathermy and physiotherapy, were included in the study. History regarding demographic status, duration of LBP, and medications used, was recorded. The severity of backache was assessed by using pain rating scores using the numeric rating scale (NRS), Prolo and Macnab criteria. Similarly, work status and functional status was assessed by Oswestry disability index 2.0 (ODI). The patients were routinely followed up in the orthopedics outpatient clinic, 6 weeks and 12 weeks. The initial (15-30 min) pain response was prospectively collected using a visual analogue scale.
Results: 60 patients with LBP between ages 20-65 years were studied. Average of patients were 50.84±7.7, out of these 32 (53.33%) were males and 28 (46.67%) females. 33(55%) patients belonged to poor families, 20 (33.33%) to average, while 7(11.67%) to rich families. The mean follow-up period was 3 months. Only 2 patients suffered from paraesthesia for 5-6 hours post injection, in the rest of the patients no complication was seen. Post-epidural back pain relieved were 50-70% in 20 (33.33%), 70-80%, 19 (31.67%), 80-90% 13 (21.67%), and 90-100% 8(13.33%). After 3 months (medium- term effect), pain relief of more than 50% persisted in 44- 48 (73.33-80%) patients. Final over view of outcome of ESIs in LBP. Functional assessment results assessed by the ODI showed significant improvement in the functional status from baseline to 3 months. Reduction of ODI scores of at least 40% was seen in 96.67% of patients at 6 weeks, and then 12 weeks (3 months).
Conclusion: ESIs are very effective and significantly reduce pain in patients with chronic function-limiting LBP.
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