title: Fluoroscopically guided caudal epidural steroid injection for management of degenerative lumbar spinal stenosis: short-term and long-term results.
abstract: OBJECTIVE
  To evaluate the short-term and long-term effects of fluoroscopically guided caudal epidural steroid injection (ESI) for the management of degenerative lumbar spinal stenosis (DLSS) and to analyze outcome predictors.
  
  
  METHODS
  All patients who underwent caudal ESI in 2006 for DLSS were included in the study. Response was based on chart documentation (aggravated, no change, slightly improved, much improved, no pain). In June 2009 telephone interviews were conducted, using formatted questions including the North American Spine Society (NASS) patient satisfaction scale. For short-term and long-term effects, age difference was evaluated by the Mann-Whitney U test, and gender, duration of symptoms, level of DLSS, spondylolisthesis, and previous operations were evaluated by Fisher's exact test.
  
  
  RESULTS
  Two hundred and sixteen patients (male:female = 75:141; mean age 69.2 years; range 48 approximately 91 years) were included in the study. Improvements (slightly improved, much improved, no pain) were seen in 185 patients (85.6%) after an initial caudal ESI and in 189 patients (87.5%) after a series of caudal ESIs. Half of the patients (89/179, 49.8%) replied positively to the NASS patient satisfaction scale (1 or 2). There were no significant outcome predictors for either the short-term or the long-term responses.
  
  
  CONCLUSIONS
  Fluoroscopically guided caudal ESI was effective for the management of DLSS (especially central canal stenosis) with excellent short-term and good long-term results, without significant outcome predictors.
authors.affiliation: Department of Radiology, Seoul National University Bundang Hospital, 300 Gumidong, Bundag-Gu, Seong Nam, Gyeongi-do, 463-707, Korea.
authors.forename: Joon Woo
authors.initials: JW
authors.lastname: Lee
authors.forename: Jae Sung
authors.initials: JS
authors.lastname: Myung
authors.forename: Kun Woo
authors.initials: KW
authors.lastname: Park
authors.forename: Jin S
authors.initials: JS
authors.lastname: Yeom
authors.forename: Ki-Jeong
authors.initials: KJ
authors.lastname: Kim
authors.forename: Hyun-Jib
authors.initials: HJ
authors.lastname: Kim
authors.forename: Heung Sik
authors.initials: HS
authors.lastname: Kang
mesh_terms: D000368:Aged; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007268:Injections, Epidural / Q000379:methods; D008137:Longitudinal Studies; D008297:Male; D015641:Radiography, Interventional / Q000379:methods*; D013130:Spinal Stenosis / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D013256:Steroids / Q000008:administration & dosage*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D013256:Steroids