Efficacy of caudal epidural steroid injection in the Management of low backache with radiculopathy

Abstract

Background: The most prevalent condition in society that leads to morbidity and socioeconomic loss is low back pain (LBP). Even though LBP resolves on its own, when it persists and is accompanied by radicular pain it causes functional limitations. NSAIDs, analgesics, oral or parenteral steroids, therapeutic exercises, and epidural injections are nonsurgical treatments for lumbar radicular pain. Lumbar and caudal methods are used to administer epidural injections. Despite the fact that there are many different therapy choices, many of them have dubious or inadequately studied results, hence we planned this study. Objective: To assess the benefits of caudal epidural steroid injection by examining the clinical and functional results in cases of low backache and lumbar radiculopathy. Materials and methods: A prospective follow-up study was carried out in the Department of Orthopaedics at Government Medical College Srinagar from May 2021 to April 2023 with the purpose of determining the effectiveness of caudal epidural steroid injection in cases of prolapsed intervertebral disc (PIVD). We used caudal epidural steroids in sterile operating rooms to treat 50 patients of LBP that matched the inclusion criteria and did not improve with non-invasive and non-surgical techniques. Our 10 ml injectable cocktail consisted of 1 ml (2%) Xylocaine + 80 mg Methylprednisolone + 8 ml Normal saline. Results: Fifty patients completed the study. After a week, 41 patients (82%) out of 50 do not report having a low backache or discomfort spreading to one or both lower limbs. However, nine individuals (18%) have a second epidural steroid injection after a month and experience either partial improvement or persistent problems after three days. Two patients from group I, three from group II, and four from group III are among the patients who required a second injection. Forty-six patients (92%) report no discomfort after one month, although four patients (8%) report some back pain that healed after two to three months of consistent physiotherapy and posture correction activities. Conclusion: Caudal ESI is a day care technique that is simple to administer. In skilled hands and with carefully chosen cases, caudal ESI is a reasonably safe treatment when carried out under sufficient aseptic circumstances. When other traditional non-surgical therapy options for people with chronic LBP are not working, ESI might be utilized as an alternative.