Title: A Study on management of lumbar disc disease with caudal epidural steroid injection
Authors: Wazir Fahad Jan, Alamgir Jahan, Mohd Yahya Dar, Umer Mushtaq Khan, Haamid Rafiq Bhat
Background: Lumbar disc disease is the most common cause of chronic low backache and radicular lower limb pain. It can lead to severe discomfort and impairment of daily activities to the patient causing both physical and mental trauma to the patient. The initial treatment of lumbar disease is conservative with analgesia, physical therapy and local epidural steroid injections. The purpose of this study was to evaluate the effectiveness of caudal epidural steroid injections in the management of pain due to lumbar disc disease.
Methods: This was a prospective observational study conducted on 70 patients of either sex with an average age of 38.14 years, presenting to the Orthopaedic OPD of SHKM Government Medical College Hospital, Nalhar, NUH, Haryana between June 2016 and October 2017, with a diagnosis of lumbar disease disc. All the patients were treated with caudal epidural injection and the results were analysed through the assessment of Visual Analog Score (VAS) and Japanese Orthopaedic Association (JOA) Score. The patients were followed up for a period of 1 year after the injection.
Results: Majority of the patients had significant relief with this method. The Visual Analog Score (VAS) and and Japanese Orthopaedic Association (JOA) Score improved from the pre-treatment values of 8.23 and 12.72 to 2.94 and 25.12 respectively, which was found to be statistically significant (p value< 0.001).
Conclusions: Thus results of our study demonstrate that the caudal epidural steroid injection is a safe and effective method of treatment of lumbar disc disease.
Level of Evidence: Therapautic level IV.
Keywords: Lumbar disc disease, caudal epidural steroid injection.