European Journal of Molecular & Clinical Medicine

Abstract

Background: A vast majority of prolapsed inter-vertebral disc (PIVD) occur at L4-L5 and L5-S1 level causing L5 and S1 radiculopathy. Lumbar epidural steroid injection (LESI) forms an important part of modern spine care, in cases not responding to conservative management for more than 3 months. Present study was aimed to study epidural methylprednisolone injection in treatment of prolapsed inter-vertebral disc (PIVD) cases.
Material and Methods: Present study was hospital based, prospective, observational study, conducted patients aged 18 to 65 years suffering from mechanical LBP with radiation due to PIVD at L4-L5 and L5-S1 (diagnosed with MRI) with symptom duration of less than 1year, symptom severity of ≥6 cm VAS score for pain, and not responding to conservative management for 3 months, received epidural steroid injection of methylprednisolone (80 mg).
Results: In present study, out of 55 enrolled patients, 42 completed follow-up. Majority were females (54.76 %), left side affected (52.38 %), Housewife (42.86 %) & labourers (26.19 %). Mean age was 38.32 ± 9.18 years, mean BMI was 27.89 ± 4.12 kg/m², average duration of pain was 13.33± 4.16 weeks. L4-L5 (61.9 %) were commonly involved as compared to L5-S1 (38.1 %). As per MRI Grading, Grade 2 (66.67 %) were more than Grade 3 (33.33 %) cases. We noted a significant improvement in Oswestry Disability Index Score (ODI) and the Visual Analogue Scale (VAS) as compared to baseline & at 6-month follow-up values, difference was highly significant (< 0.001).
Conclusion: Epidural use of methyl prednisone is safe and efficacious treatment modality in management of low back pain and radicular pain due to a prolapsed lumbar intervertebral disc.