THE EFFICACY OF EPIDURAL STEROID INJECTIONS IN THE MANAGEMENT OF PATIENTS WITH LUMBOSACRAL DEGENERATIVE SPINE DISEASES
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 28
Abstract
BACKGROUND Degenerative diseases of the lumbosacral region are becoming a more frequent presentation to the clinician, particularly with the increasing ageing population worldwide. These conditions result in impingement of the nerve roots and inflammation, causing radiculopathy along the course of the affected nerve root. Epidural steroid injections are commonly employed to alleviate the radiculopathy when the use of conservative methods of treatment have failed. The objective of the study was to determine the efficacy of this treatment modality in our setting. MATERIALS AND METHODS This study was an observational study carried out at the Jos University Teaching Hospital, Nigeria. Patients who had epidural steroids within one-year period (July 2016 - June 2017), who were being managed for degenerative spine disease of the lumbosacral region were included in the study. The data was obtained from the case records of the patients. Epidural steroids were administered under sterile conditions. 80 mg of Methylprednisolone was used with 3 mL of 1% lignocaine. This was administered via the interlaminar route to the epidural space. The patients’ responses were assessed using the numeric pain scale (11-point scale from 10 to 0). Data was analysed using Statistical Package for Social Sciences (SPSS). Pain before the procedure, pain after the procedure and the pain differential on the scale were assessed as well as complications. The paired t-test was used to analyse the mean pain scores at 95% confidence interval and a p-value < 0.05 was considered statistically significant. RESULTS A total of 34 patients were involved in the study. 11 males and 23 females with a male: female ratio of 1: 2.1. The ages of the patients ranged from 20 to 80 years with a mean age of 57.2. The pathologies were disc degeneration and herniation 21 (61.8%), degenerative spondylolisthesis 6 (17.5%), spinal canal stenosis 4 (11.8%) and prolapsed intervertebral disc 3 (8.8%). The mean score before the procedure was 8.8 ± 0.81; 6 (17.6%) patients scored 10, 17 (50%) scored 9, 9 (26.5%) scored 8 and 2 (5.9%) scored 7. Mean pain scores after the procedure was 2.2 ± 1.34; 14 (41.2%) patients scored 1, 9 (26.5%) scored 2, 5 (14.7%) scored 3, 4 (11.8%) scored 4 and 1 each (2.9%) scored 5 and 6; 31 (85.3%) patients had a reduction by 50% or more in their pain scores. A statistically significant difference (t= 25.09; p < 0.000 at 95% confidence interval) was observed between the mean pain scores before and after epidural steroid injection. CONCLUSION Epidural steroid injections are a safe and effective method of treating patients with radiculopathy from lumbosacral degenerative spine diseases.
Authors and Affiliations
Ode M. B, Taiwo F. O, Amupitan I, Onoja A. A, Mancha D. G, Nkinyam G. Y
Keywords
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- EP ID EP537944
- DOI 10.14260/jemds/2018/723
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