Efficacy of epidural steroid injection in lumbar disc disease

Abstract

Purpose: Lumbar epidural steroid injection is a reasonable non-surgical option available in lumbar disc disease. We have a number of studies that have compared epidural steroid injections with discectomy for the treatment of lumbar disc herniation. There are only a few studies which throw light on conservative management of lumbar disc herniation. We intended to study and compare the effect and outcome of conservative (non-invasive) and epidural steroid injection (invasive but conservative). Methods: In the year 2017 to 2018, a total of 100 cases of lumbar disc disease were randomnly grouped into 2 groups of 50 each and one group treated with conservative measures and the other group with epidural steroid injection. Results: The patients were followed up for a period of 1 year and were evaluated according to ODI and VAS scores taken preprocedure and on follow up visits. Thirty six percent of patients had either protrusion or extrusion of the lumbar disc. Irrespective of the magnitude of disc herniation, the cohort which was treated with epidural steroid injection showed significant improvement in symptoms. Beyond doubt steroid definitely helps control the chemical inflammation causing nerve root irritation which is believed to play a critical role in the genesis of radicular pain with and without the presence of mechanical compression of the nerve roots or cord. Conclusion: Epidural steroid injection probably accelerates pain relief in patients who eventually have natural resolution of radicular pain in a gradual delayed fashion. Epidural steroid could allow faster return to function during the natural history of sciatica.