Therapeutic Effect of Epidural Steroid Injection in Patients Suspected of having an Internal Disc Disruption: A Prospective Case Study

Abstract

Purpose: To assess the effect of the epidural steroid injection for patients suspected of having an internal disc disruption. Materials and Methods: Thirteen patients at the pain intervention clinic that received a lumbar interlaminar epidural steroid injection and were suspected of having an internal disc disruption were prospectively enrolled in this study. The treatment outcome was assessed using a 5-point patient satisfaction scale (no pain, improved, slightly improved, effect, aggravated) two weeks after injection. A successful outcome required a patient satisfaction scale of much improved or no pain. All patients received follow-up for two months. Two radiologists evaluated the presence of HIZ (high intensity zone), a dark disc by MR (n = 10) and a diffuse bulging disc by CT (n = 3). Results: Nine (69%) of the 13 patients achieved a successful outcome two weeks after injection. These nine patients showed recurrence during the two months months follow-up. Of the 22 abnormal discs demonstrated by MRI and CT, MRI showed a dark disc in six patients and HIZ in 13 patients. CT showed diffuse bulging in three discs. Nine of 10 patients showed at least one HIZ. Conclusion: An lumbar interlaminar epidural steroid injection might be an effective tool for managing patients suspected of having an internal disc disruption.