Role of Caudal Epidural Injection in Managing Failed Back Syndrome: One Year Follow Up Result of A Randomized Study
Journal Title: International Journal of Contemporary Medical Research - Year 2017, Vol 4, Issue 1
Abstract
Introduction: There is an increasing prevalence of low back pain in the modern era, which is associated with wide range of diagnostic and therapeutic modalities. The Spine Patient Outcomes Research Trial (SPORT) have demonstrated vast improvement in patients who have undergone surgical interventions compared to conservative treatment modalities. The present study is a one year follow up of 112 patients of post lumber surgery syndrome who suffered from chronic low back and lower extremity pain after being surgically treated for the same. Material and Methods: This prospective randomized study included 112 patients. They were divided into two groups of 56 patients each.Group I received 0.5% lignocaine, 10 mL; Group II received 8 mL of 0.5% lignocaine mixed with 2 mL of methylprednisolone. The multiple outcome measures included the numeric rating scale, the Oswestry Disability Index assessments at 3, 6, 12 months posttreatment.Atleast 50% improvement in pain and Oswestry Disability Index scores was considered as primary outcome. Successful response was considered only in cases of positive response to the first 2 procedures with at least 3 weeks of relief. All others were considered as failures. Results: Overall in Group I, 55% of the patients and in Group II, 61% of the patients, showed significant improvement with reduction in pain scores and disability index at 12 months. The results in the successful group showed that at the end of the first year patients experienced approximately 28.5 and 30.7 weeks of relief in group I and group II respectively. The average procedures in the successful groups were at 3.5 in one year. Conclusion: Caudal epidural injections of local anesthetic with or without steroid is an effective alternative to treat patients with chronic persistent low back and/or lower extremity pain in patients with post lumbar surgery syndrome.
Authors and Affiliations
Kapil Bansal, Anshul Dahuja, Sabyasachi Bhowmik, Mamta Gupta, Rash meet
Keywords
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