Comparing the effects of epidural methylprednisolone acetate injected in patients with pain due to lumbar spinal stenosis or herniated disks: a prospective study

Abstract

ObjectiveSatisfactory results have been seen with epidural steroid injections (ESI) in patients with herniated disks (HD), but the role in lumbar spinal stenosis (LSS) has been less investigated. We compared long-term effects of ESI in HD and LSS patients.MethodsIn a prospective, single-blind uncontrolled study, 60 patients with radicular pain due to HD (n = 32) or LSS (n = 28) were enrolled over a 9-month period. Methylprednisolone acetate 80 mg plus 0.5% bupivacaine 10 mg were diluted in normal saline up to a total volume of 10 mL, and injected into the epidural space. The amount of pain based on numeric pain score, level of activity, and subjective improvement were reported by patients after 2 and 6 months by telephone. Demographic data were analyzed with the chi-square test. The differences in numeric pain scale scores between the two groups at different times were analyzed with the t-test.ResultsThere were no differences between HD and LSS patients regarding age, sex, and average duration of pain prior to ESI. The degree of pain was significantly higher in LSS patients in comparison with HD patients in the pre-injection period. The amount of pain was significantly reduced in both groups 2 months after injection. This pain reduction period lasted for 6 months in the HD group, but to a lesser extent in LSS patients (P < 0.05).DiscussionEpidural methylprednisolone injection has less analgesic effect in LSS, with less permanent effect in comparison with HD.

Efficacy of Transforaminal Steroid Block for Pain Relief Due to Recurrent Lumbar Disc Herniation in Previously Operated Case of Lumbar Discectomy

“…While performing the procedure the needle should not be handled roughly when the treatment is being performed because we only expect to lightly contact the nerve root. The majority of publications advice against doing this to avoid needle-induced problems, however none occurred in our study [17][18][19][20]. Using a quantitative pain rating scale, we assessed pain both before and after the procedure.…”

“…The prognosis for these people varies depending on the specific condition still causing the inflammation of the nerve root. Many authors have used methyl prednisolone-based preparations for this purpose [18]. Manchikanti et al demonstrated Transforaminal injections of local anaesthetic with or without steroids might be an effective therapy for patients with disc herniation.…”

Wasting of extensor digitorum brevis as a decisive preoperative clinical indicator of lumbar canal stenosis: A single-center prospective cohort study

“…[ 10 ] Besides the anteroposterior diameter (<10 mm) and cross-sectional area (<70 mm) of spinal canal, MRI finding of positive sedimentation sign is a good positive sign to rule in lumbar spinal stenosis with high specificity and sensitivity. [ 11 12 ] Lumbar canal stenosis was mostly observed in the age group of 50–60 years. Diagnosis for L3–L4 canal stenosis was made in 44/120 (36.6%), L5/S1 in 52/120 (43.3%), and L3/L4/L5 level in 48/120 (40%) of patients in our study group.…”

The Outcomes of Selective Nerve Root Block for Disc Induced Lumbar Radiculopathy

“…Many authors have used methyl prednisolone based preparations for this purpose 12 . Triamcinolone and betamethasone based preparations are also in use 13 .…”