Comparison of the effectiveness of caudal and transforaminal epidural block in the patients with low back pain syndrome due to degenerative-dystrophic changes of spine

Abstract

The study included 258 (96 males, 162 females) of patients in the age of 52.2±14.16 years with pain in the lumbar-sacral part of spine due to degenerative-dystrophic changes. Among them: 30 patients received medication treatment (group 1, control), 114 transforaminal epidural block (group 2) and 114 — caudal epidural blockades (group 3, n = 114). Period of observation was 6 months. The assessment of the intensity of the pain was performed on the visual analog scale (VAS), the quality of life — on the Oswestry Disability Index (ODI) and the Short Form Health Survey-36 (SF-36). Caudal and transforaminal epidural blockades could effectively reduce the intensity of pain (p<0.05). 98.2% of patients reported regression of pain immediately after caudal epidural blockades, but the positive result remained during 6 months after procedure in only 59.6% of patients. Transforaminal epidural block contributed to a significant decrease the intensity of pain according to the VAS in the whole group and different monitoring periods in 76.4–91.2% of patients. Both methods are effective for treatment of the lumbar pain syndrome and are associated with a positive dynamic of patient quality of life. However, caudal epidural blockades are more effective in the short term.