Abstract
Aim
Assess efficacy of caudal epidural injection with epidurogram with validated outcome measures.
Introduction
The administration of local steroids and other drugs into caudal epidural space has been well established procedure in the management of low back pain with or without leg symptoms. Various studies have been done to assess the efficacy of the different routes of administration of epidural injections. However, only a few published prospective studies have been done on performing caudal epidural injections under fluoroscopic guidance with validated outcome measures.
Methods
Between 2007 and 2009, a total of 129 patients underwent caudal epidural injections under image intensifier guidance with epidurogram. The study included 69 males and 60 females ranging from 20 to 80 years of age. They were prospectively followed up using validated outcome measures at 6 weeks, 3 months, 6 months and 12 months.
Results
Out of 129 patients 120 patients were followed at one year. There was statistically significant improvement in mean Low Back Outcome Score (LBOS) and Oswestry Disability Index (ODI) Scores in these patients which was maintained at the end of one year.
Based on LBOS and ODI scores, 76% of patients at 6 weeks, 68% at 3 months, 55% at 6 months and 49% at 1 year had excellent and good results. Patients with less than two levels of degenerative disc disease, with predominant unilateral leg symptoms and with symptomatic duration of less than 6 months had a better outcome of results when compared with patients with predominant back symptoms, multi-level degenerative disc disease, bilateral involvement and history of previous lumbo-sacral spine surgery.
Discussion and Conclusion
Our study on caudal epidural injections done under fluoroscopic guidance indicate improved and predictable outcome in addition to the patient satisfaction.
