EFFECT OF SINGLE DOSE EPIDURAL STEROID + LOCAL ANAESTHETIC INJECTION ON PAIN FREE WALKING DISTANCE IN PATIENTS OF LUMBAR CANAL STENOSIS WITH NEUROLOGICAL CLAUDICATION
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Keywords
lumbar or spinal stenosis, epidural steroid & LA injection, neurological claudication.
Abstract
Background: Many patients who genuinely require spine decompression remain afraid or reluctant to undergo operation due to expected cost and complications. Analgesics can not be given for prolonged period. In between surgery and analgesics comes the option of epidural steroid + local anaesthetic injection which was evaluated in this study.
Methods: Twenty patients of lumbar canal stenosis with neurological claudication were given Methyl-prednisolone + Bupivacaine injection in epidural space under image intensifier guidance. Pain-free walking distances were measured as number of steps using smart watch before giving injection, 10 days after injection and 90 days after injection.
Result: Mean pain-free walking distance increased by 121% from 265.5 at pre-injection state to 589.1 at ten days after injection, and by 104% at 90 days after injection. No complication was observed.
Conclusion: Epidural steroid + LA injection may be used to avoid or postpone the spine surgery in some patients especially if patient if reluctant or afraid to surgery. The procedure is safe without major complications.
References
2. Buenaventura RM et al., Systematic review of therapeutic lumbar transforaminal epidural steroid injections; Pain Physician, 2009, Jan-Feb, 12 (1) ; 233-51.
3. Jakub Jezek et al., Ligamentum flavum: changes in vascular density, physical and histopathological properties in lumbar spine based on anatomical localization, spinal segment levels and presence of lumbar spinal stenosis; North America Spine Society journal, Vol 24, Dec 2025, 100782.
4. Sang Beom Kim et al., The additional effect of hyaluronidase in lumbar interlaminal epidural injection; Annals of rehabilitation medicine, 2011, June 30, 35(3) : 405-411.
5. Mina Maher Raouf et al., Dexmedetomidine versus hyaluronidase along with lumbar transforaminal epidural steroid injection in failed back surgery: a randomized double blind; Anaesthesia & pain medicine, Jan 2025: 20(1): 61-71.
6. Riew K D et al, The effect of nerve root injections on the need for operative treatment of lumbar radicular pain. A prospective, randomized, controlled double-blinded study; JBJS (A), Nov 2000, 82-A (11): 1589-93.
7. Buttermann GR et al., Treatment of lumbar disc herniation; epidural steroid injection compared with discectomy. A prospective randomized study; JBJS (A), April 2004, 86-A (4): 670-9.
8. Radcliff K, Hilibrand A et al., The impact of epidural steroid injections on the outcomes of patients treated for lumbar disc herniation: a subgroup analysis of the SPORT trial; JBJS (A), Aug 2012, 94(15): 1353-8.
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Dr. Anjani Kumar Singh
Associate Professor, Department of Orthopaedics, Srinivas (G) Educational & Research Institute of Medical Sciences, Chhapra, Bihar, India.