Sandeep Kumar Gupt1, Rachit Gulati2, Reni Benny3, Shashank Yeshwant Kothari4
BACKGROUND
Epidural steroid injections (ESIs) have been widely used for over 50 years in the
treatment of back pain with or without radiculopathy. In this study, we intended
to evaluate the effect of single caudal epidural steroid injection (CESI) in patients
suffering from chronic lumbago-sciatica syndrome, resistant to conservative
medical therapy.
METHODS
This was a retrospective study. CESI was performed on thirty-four patients
suffering from chronic lumbago-sciatica syndrome, from April 2019 to March 2020.
Single injection of caudal epidural steroid (40 mg Triamcinolone Acetonide) diluted
with 10 ml. of sterile water was given guided by anatomic landmark, confirmed by
“Whoosh” test and radiologically with dye. Patients were followed for 12 weeks
using Numeric Rating Scale (NRS) for pain, Oswestry disability index (ODI) and
North American spine society patient satisfaction index (NASS). Values were
recorded before the injection and after the injection at 1 week, 3 week, 6 week
and 12 week during follow-up.
RESULTS
Significant improvement in patient’s status was observed after CESI, as measured
with NRS, ODI and NASS at one, three, six and twelve weeks as compared to pre
injection (zero week) but no significant difference was observed at successive
follow ups at first to third and third to six weeks. There was significant reversal of
NRS and ODI Score from 6 week to 12 week follow-up. Sixty seven percent of
patients were satisfied at the end of the follow-up and mild side-effects were
reported in a few patients.
CONCLUSIONS
CESI is a safe, simple and cost-effective intervention procedure for the treatment
of chronic lumbago-sciatica syndrome. It provides rapid pain relief and physical
function improvement of the patient starting within a week.
