Caudal epidural steroids in management of lumbar radiculopathy

Abstract

Introduction: Practice of epidural steroid injections have been used in the past in for lumbar radiculopathy. We observed and analysed outcomes of caudal epidural steroid injections in the management of lumbar radiculopathy due to disc herniations. Methods: In this study, 45 patients with lumbar radiculopathy due to disc herniation between the ages of 18-50 confirmed by MRI were included in the study. All patients were given a suspension of Methyl prednisolone along with local anaesthetic through caudal epidural route and the results were analysed. Results: Majority of the patients [64.5%] had significant pain relief measured by VAPS, ODI and SLRT and could avoid surgery. 13 patients opted for surgery due to failure of epidural steroid injections. None of the patient had deterioration of pain or disability as compared to pre-injection status. Conclusion: Patient with predominant radicular pain due to lumbar disc herniation can be considered for treatment with caudal epidural steroids prior to being considered for operative intervention. Caudal epidural steroids offer a cost effective and low risk alternative to surgery.