title: Effectiveness of epidural steroid injection for the management of symptomatic herniated lumbar disc.
abstract: Low-back pain is a common clinical presentation of herniated lumbar disc. This is the most common presenting complain of the young adults. The incidence of low back pain is high in our part of the world. The reason may be hilly terrain, difficult working and living environment. The initial treatment of low back pain is conservative. Epidural steroid injection (ESI) is being slowly established as a simple, effective and minimally invasive treatment modality. The aim of this study is to assess the effectiveness of epidural steroid injection for low back and radicular pain. This is a Prospective observational study. It was carried out on the patients presenting with the complain of low back and radicular pain due to herniated lumbar disc not responding to conservative treatment. All the patients of herniated lumbar disc were proven by Magnetic Resonance Imaging (MRI). Injection Methyl prednisolone 80 mg and 2 ml of 0.5% bupivacaine was diluted in 8 ml of normal saline and injected into the affected lumbar epidural space. The functional status of the patient and the severity of pain were evaluated before injection and after injection during the follow-up period by using Ostrewy disability index and visual analogue score. Sixty two patients received the epidural steroid injections, but only fifty patients came for regular follow up till six months. Among the fifty patients, 26 were male and 24 were female. The functional status and pain response of the patients were improved significantly during all the follow-up periods (p < 0.001). The success rate of this study was 81%. No major complications were encountered. The ESI is a simple, safe, effective and minimally invasive modality for the management of symptomatic herniated discs.
authors.affiliation: Department of Anaesthesiology and Critical Care, Norvic International Hospital, Kathmandu, Nepal. bidur_baral@yahoo.com
authors.forename: B K
authors.initials: BK
authors.lastname: Baral
authors.forename: R R
authors.initials: RR
authors.lastname: Shrestha
authors.forename: A B
authors.initials: AB
authors.lastname: Shrestha
authors.forename: C K
authors.initials: CK
authors.lastname: Shrestha
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007268:Injections, Epidural; D007278:Injections, Spinal; D007405:Intervertebral Disc Displacement / Q000188:drug therapy*; D008159:Lumbar Vertebrae; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage / Q000627:therapeutic use*; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D008775:Methylprednisolone