title: Comparison of two methods of epidural steroid injection in the treatment of recurrent lumbar disc herniation.
abstract: METHODS
  Prospective study.
  
  
  OBJECTIVE
  We compared the effects of two methods of epidural steroid injection in patients with recurrent disc herniation.
  
  
  BACKGROUND
  To our knowledge, there is no previous report of such a comparison in these patients.
  
  
  METHODS
  The study was performed with 30 patients with relapsed lumbar disc herniation whose pain was not relieved by conservative remedies. The patients were divided into two groups, each of 15 patients, and entered the study for caudal or transforaminal injections. The degree of pain, ability to stand and walk, and the Prolo function score were evaluated in both groups before the injection and 2 months and 6 months after the injection.
  
  
  RESULTS
  The degrees of pain reduction in the caudal injection group in the second and sixth months were 0.6 and 1.63, respectively, and in the transforaminal injection group were 1.33 and 1.56, respectively. The difference between the two methods was not statistically significant. Similarly, no other evaluated criterion showed a significant difference between the methods.
  
  
  CONCLUSIONS
  In the current study, the caudal and transforaminal steroid injection methods showed similar outcomes in the treatment of relapsed lumbar disc herniation. However, more detailed patient categorizing may help in finding possible subgroups with differences.
authors.affiliation: Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran. ; Afzal Research Institute (NGO), Kerman, Iran.
authors.forename: Saeid
authors.initials: S
authors.lastname: Karamouzian
authors.affiliation: Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Ebrahimi-Nejad
authors.affiliation: Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran.
authors.forename: Shahram
authors.initials: S
authors.lastname: Shahsavarani
authors.affiliation: Neurosurgery Department, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Ehsan
authors.initials: E
authors.lastname: Keikhosravi
authors.affiliation: Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Shahba
authors.affiliation: Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran.
authors.forename: Farzaneh
authors.initials: F
authors.lastname: Ebrahimi
keywords: Caudal; Epidural steroid; Lumbar spine; Recurrent disc herniation; Transforaminal