Efficacy of Ultrasound-Guided Caudal Epidural Calcitonin for Patients with Failed Back Surgery Syndrome

• Published in: Anesthesia, essays and researches Vol. 14; no. 1; pp. 132 - 136
• Main Authors: El-Emam, El-Sayed M, El Motlb, Enas A Abd
• Format: Journal Article
• Language: English
• Published: India Wolters Kluwer - Medknow 01.01.2020
• Subjects: Original; failed back surgery syndrome; Calcitonin; caudal epidural
• ISSN: 0259-1162; 2229-7685
• DOI: 10.4103/aer.AER_98_19

Pain resulting from failed back surgery syndrome (FBSS) is generally resistant to physiotherapy and pharmacological treatment. The aim of this study is to evaluate the effect of adding calcitonin to local anesthetic and steroids during ultrasound-guided caudal epidural injection for patients suffering from FBSS. Fifty-six patients were randomly allocated into two equal groups. All patients underwent ultrasound-guided caudal epidural injection. Group A received 40 mg (1 mL) methylprednisolone +9 mL lidocaine 0.5% + 1500 iu hyaluronidase in 10 mL normal saline, whereas Group B received 40 mg (1 mL) methylprednisolone +9 mL of 0.5% lidocaine + 1500 iu hyaluronidase in 5 mL normal saline + 50 iu calcitonin in 5 mL normal saline. A statistically significant decrease in visual analog scale, Oswestry Disability Index, and analgesic consumption was recorded in Group B as compared to Group A at 1, 2, and 3 months interval. No side effects were reported in Group A, whereas patients belong to Group B experienced nausea (2 cases), and diuresis for 24 h was detected in two cases. The addition of calcitonin to epidural steroid and local anesthetic injection resulted in better Oswestry disability scale, diminished pain intensity, and less analgesic consumption.