Purpose
Low back pain of mechanical origin is a major cause of disability and surgical intervention ( IQ ) .
Lumbar steroid injection can accelerate the recovery process and sometimes Avoid IQ.
Our purpose in the present study is:
-To describe the procedure including thecnique details,
risk and complications
-To review the indications,
efficacy and complications of this technique in a wide series ofunselected patients.
-To compare theefficacy according to the lumbar underlying pathology,
type of steroidand approach of injection.
Methods and Materials
Retrospective study of lumbar CT-guided steroid injections performed in a University Hospital between January 2012 and June 2015.
The minimum follow-up was 3 months.
The procedure was performed in patients with low back pain refractory to standard medical therapy and Lumbar SpineRehabilitation.
Efficacy was assessed at 1 and 3 months according to a semiquantitative scale as the pain response as a) totalresponse,
b) partially c) no or d) worsening pain.
A comparative study of the efficacy and safety was performed,
regarding: a) underlying pathology,
b)...
Results
During the study period 258 procedures were performed in 171 patients (132 men / 126 women) with a mean age ± SD of 58.24±13.45 years (range,
18-88).
The indications for the injection were: a) disc herniation (44.57%),
b) lumbar stenosis (34.11%),
c)postoperative fibrosis and spondylolisthesis (20.15%) and d) facet joint synovial cysts syndrome (1.17%) Fig. 12 .
Approaches used were: a) posterior epidural (24.42%),
b) lateral recess (58.91%),
and c) foraminal (16.67%) Fig. 13 .
The chosen steroid was triamcinolone (74.81%),
dexamethasone (23.64%) and methylprednisolone...
Conclusion
CT-guided corticosteroid injection is an effective and safe treatment in low back pain refractory to standardmedical therapy in patients with spinal stenosis,
disc herniation and postoperative fibrosis.
Triamcinolone infiltration seems to be more effective than dexamethasone.
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Eckel T.S.
et al.
Epidural Steroid Injections and Selective...
