Role of psoas compartment and caudal epidural steroid injection in spinal stenosis patients associated with low back pain and lower limb radiculopathy.
OBJECTIVE
To study the efficacy, safety and patient satisfaction of psoas compartment and caudal epidural steroid injection in patients with spinal stenosis and lumbosaccral radiculopathy.


METHODS
Patients with a diagnosis of spinal stenosis and lumbosaccral radiculopathy having visual analogue score (VAS) less than five were included in the study. Bilateral psoas compartment and caudal epidural injection was given to all patients. In group-A patients haemodynamics and complications were examined immediately after injection. In group-B the same patients were examined through a questionnaire after eight weeks, for pain relief, duration of pain relief, reduction in painkillers and overall improvement in activities of daily living.


RESULTS
Total 106 patients were examined. In group-A change in haemodynamics before and after twenty minutes of injection was less than 15 percent and no immediate complications were reported. In group B more than 90 percent of patients reported relief of pain and VAS remained below three. Relief of pain lasted for 1-2 weeks, 2-4 weeks, 4-6 weeks and 6-8 weeks in 13 percent, 11 percent, 27 percent and 43 percent of patients respectively. More than fifty percent of patients reported up to 70 percent improvement in activities of daily living (ADL) and reduction in weekly intake of supplemental pain killers. Six percent of the (seven) patients reported no response to treatment.


CONCLUSIONS
Psoas compartment and caudal epidural steroid injection could be an alternate option for pain relief in patients with spinal stenosis and lumbosaccral radiculopathy.
Department of Anaesthesia and Intensive Care, Aga Khan University.
Mueen Ullah
MU
Khan
S Zaki
SZ
Hussain
D000203:Activities of Daily Living; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D002045:Bupivacaine / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007268:Injections, Epidural; D017116:Low Back Pain / Q000188:drug therapy* / Q000209:etiology / Q000523:psychology; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use*; D008875:Middle Aged; D010147:Pain Measurement; D017060:Patient Satisfaction; D011446:Prospective Studies; D016658:Psoas Muscles / Q000187:drug effects*; D011594:Psychometrics; D011843:Radiculopathy / Q000188:drug therapy*; D013130:Spinal Stenosis / Q000150:complications / Q000188:drug therapy* / Q000523:psychology; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents; D008775:Methylprednisolone; D002045:Bupivacaine