title: Symptoms of spinal stenosis do not improve after epidural steroid injection.
abstract: OBJECTIVE
  This study was carried out to evaluate the therapeutic effect of epidural steroid injection on pseudoclaudication in patients with lumbar degenerative spinal canal stenosis.
  
  
  METHODS
  Fifty-three patients who complained of pseudoclaudication of less than 20 m in walking distance were randomly divided into three groups. Group 1 (n = 16) underwent epidural injection with 8 ml of saline. Group 2 (n = 18) underwent epidural block with 8 ml of 1% mepivacaine. Group 3 (n = 19) underwent epidural block with a combination of 8 ml of 1% mepivacaine and 40 mg of methylprednisolone. The criteria of evaluation were as follows: excellent effect, > 100 m in walking distance; good effect, 20-100 m in walking distance; poor effect, <20 m in walking distance.
  
  
  RESULTS
  In group 1, the numbers of patients who showed a good effect were two (12.5%) after 1 week, one (6.5%) after 1 month, and one (6.5%) after 3 months. In group 2, the numbers of patients who showed a good or excellent result were 10 (55.5%) after 1 week, three (16.7%) after 1 month, and one (5.6%) after 3 months. In group 3, the numbers of patients who showed a good or excellent result were 12 (63.2%) after 1 week, three (15.8%) after 1 month, and one (5.3%) after 3 months. There was no significant difference in the effectiveness of treatment between group 2 and group 3 throughout the time course.
  
  
  CONCLUSIONS
  The results suggest that epidural steroid injection has no beneficial effect on the pseudoclaudication associated with spinal canal stenosis as compared with epidural block with a local anesthetic alone.
authors.affiliation: Department of Anesthesia, Nagasaki Rosai Hospital, Sasebo Nagasaki, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Fukusaki
authors.forename: I
authors.initials: I
authors.lastname: Kobayashi
authors.forename: T
authors.initials: T
authors.lastname: Hara
authors.forename: K
authors.initials: K
authors.lastname: Sumikawa
mesh_terms: D000368:Aged; D015360:Analgesia, Epidural; D000779:Anesthetics, Local / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D004338:Drug Combinations; D005260:Female; D006801:Humans; D007268:Injections, Epidural; D007383:Intermittent Claudication / Q000188:drug therapy* / Q000209:etiology*; D008161:Lumbosacral Region; D008297:Male; D008619:Mepivacaine / Q000627:therapeutic use; D008775:Methylprednisolone / Q000627:therapeutic use*; D009407:Nerve Block; D013130:Spinal Stenosis / Q000150:complications*; D017211:Treatment Failure
chemical_list: D000779:Anesthetics, Local; D000893:Anti-Inflammatory Agents; D004338:Drug Combinations; D008619:Mepivacaine; D008775:Methylprednisolone