Abstract
Introduction
Epidural steroid injection is an established treatment modality for intervertebral disc prolapse. It is a low-risk alternative to surgical intervention in some patients for whom noninvasive treatment has failed. Caudal epidural steroid injection is one of the most widely used methods for pain relief. The aim of this study was to determine the significance of same dose in different volume of caudal epidural steroid injection in the treatment of lumbar degenerative disc disease.
Material/Methods
Prospective study was conducted during 2007 to 2009. 100 Patients were randomized in to two groups, of which 50 % (group A) received 4 ml of steroid with isotonic saline and remaining 50 % (group B) received 12 ml. Injection was given in prone position through a 22-G needle in to the epidural space through the sacral hiatus. The average follow-up was 18 months. Outcomes scores included the SF-36, Oswestry disability index and pain VAS and were recorded in the pre and post injection periods.
Results
In group A, 18 patients had significant pain relief and 32 had no relief during the early period. Whereas in group B, 22 had significant pain relief and 28 had no relief. The quality of pain relief of 50% or greater was considered as significant. Follow up after 1 year does not show much difference. Group B had significant decrease in symptoms in the initial post injection period (P<0.05).
Conclusions
The volume of steroid solution in the treatment of lumbar degenerative disc disease is significant in the early post injection period only.
