Fluoroscopically guided caudal epidural steroid injection for management of degenerative lumbar spinal stenosis: short-term and long-term results

• Published in: Skeletal radiology Vol. 39; no. 7; pp. 691 - 699
• Main Authors: Lee, Joon Woo, Myung, Jae Sung, Park, Kun Woo, Yeom, Jin S., Kim, Ki-Jeong, Kim, Hyun-Jib, Kang, Heung Sik
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01.07.2010; Springer; Springer Nature B.V
• Subjects: Aged; Anti-Inflammatory Agents - administration & dosage; Biological and medical sciences; Diseases of the osteoarticular system; Diseases of the spine; Female; Humans; Imaging; Injections, Epidural - methods; Investigative techniques, diagnostic techniques (general aspects); Longitudinal Studies; Male; Medical sciences; Medicine; Medicine & Public Health; Nuclear Medicine; Orthopedics; Osteoarticular system. Muscles; Pathology; Patient satisfaction; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Radiography, Interventional - methods; Radiology; Scientific Article; Spinal canal; Spinal Stenosis - diagnostic imaging; Spinal Stenosis - drug therapy; Stenosis; Steroids - administration & dosage; Tomography, X-Ray Computed - methods; Treatment Outcome; Steroid; Caudal epidural steroid injection; Spine intervention; Lumbar spine; Spinal stenosis; Short term; Nuclear medicine; Diseases of the osteoarticular system; Spine disease; Lumbar spinal stenosis; Long term; Extradural; Orthopedics
• ISSN: 0364-2348; 1432-2161
• DOI: 10.1007/s00256-009-0860-1

Objective To evaluate the short-term and long-term effects of fluoroscopically guided caudal epidural steroid injection (ESI) for the management of degenerative lumbar spinal stenosis (DLSS) and to analyze outcome predictors. Materials and methods All patients who underwent caudal ESI in 2006 for DLSS were included in the study. Response was based on chart documentation (aggravated, no change, slightly improved, much improved, no pain). In June 2009 telephone interviews were conducted, using formatted questions including the North American Spine Society (NASS) patient satisfaction scale. For short-term and long-term effects, age difference was evaluated by the Mann–Whitney U test, and gender, duration of symptoms, level of DLSS, spondylolisthesis, and previous operations were evaluated by Fisher’s exact test. Results Two hundred and sixteen patients (male:female = 75:141; mean age 69.2 years; range 48 ∼ 91 years) were included in the study. Improvements (slightly improved, much improved, no pain) were seen in 185 patients (85.6%) after an initial caudal ESI and in 189 patients (87.5%) after a series of caudal ESIs. Half of the patients (89/179, 49.8%) replied positively to the NASS patient satisfaction scale (1 or 2). There were no significant outcome predictors for either the short-term or the long-term responses. Conclusion Fluoroscopically guided caudal ESI was effective for the management of DLSS (especially central canal stenosis) with excellent short-term and good long-term results, without significant outcome predictors.