Fluoroscopically guided caudal epidural steroid injection for management of degenerative lumbar spinal stenosis: short-term and long-term results.
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.
Lee
Joon Woo
JW
Department of Radiology, Seoul National University Bundang Hospital, 300 Gumidong, Bundag-Gu, Seong Nam, Gyeongi-do, 463-707, Korea.
Myung
Jae Sung
JS
Park
Kun Woo
KW
Yeom
Jin S
JS
Kim
Ki-Jeong
KJ
Kim
Hyun-Jib
HJ
Kang
Heung Sik
HS
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
D000893:Anti-Inflammatory Agents; D013256:Steroids