English

Abstract

BACKGROUND Epidural steroid injections (ESIs) have been widely used for over 50 years in the treatment of back pain with or without radiculopathy. In this study, we intended to evaluate the effect of single caudal epidural steroid injection (CESI) in patients suffering from chronic lumbago-sciatica syndrome, resistant to conservative medical therapy. METHODS This was a retrospective study. CESI was performed on thirty-four patients suffering from chronic lumbago-sciatica syndrome, from April 2019 to March 2020. Single injection of caudal epidural steroid (40 mg Triamcinolone Acetonide) diluted with 10 ml. of sterile water was given guided by anatomic landmark, confirmed by “Whoosh” test and radiologically with dye. Patients were followed for 12 weeks using Numeric Rating Scale (NRS) for pain, Oswestry disability index (ODI) and North American spine society patient satisfaction index (NASS). Values were recorded before the injection and after the injection at 1 week, 3 week, 6 week and 12 week during follow-up. RESULTS Significant improvement in patient’s status was observed after CESI, as measured with NRS, ODI and NASS at one, three, six and twelve weeks as compared to pre injection (zero week) but no significant difference was observed at successive follow ups at first to third and third to six weeks. There was significant reversal of NRS and ODI Score from 6 week to 12 week follow-up. Sixty seven percent of patients were satisfied at the end of the follow-up and mild side-effects were reported in a few patients. CONCLUSIONS CESI is a safe, simple and cost-effective intervention procedure for the treatment of chronic lumbago-sciatica syndrome. It provides rapid pain relief and physical function improvement of the patient starting within a week. KEYWORDS Injections, Epidural, Sciatica, Low Back Pain