Caudal Epidural Steroid Injection for Low Back Pain and Lumbar Radiculopathy in a Tertiary Care Center

Rajesh  Arya; Usha  Kiran

doi:10.51168/sjhrafrica.v5i12.1490

Authors

Rajesh Arya Assistant Professor, Department of Orthopaedics, MGM Medical College, Jamshedpur, Jharkhand, India
Usha Kiran MS, Department of Obstetrics & Gynaecology, Mata Chano Devi Clinic, Purnea, Bihar, India

DOI:

https://doi.org/10.51168/sjhrafrica.v5i12.1490

Keywords:

Low Back Pain, Lumbar Radiculopathy, Caudal Epidural Steroid Injection, MRI Findings, Pain Management, Spinal Pathologies

Abstract

Background: Low back pain (LBP) with lumbar radiculopathy is common and affects daily life. Disc herniation and spinal stenosis often cause chronic pain and disability in lumbar radiculopathy. Minimumly invasive caudal epidural steroid injections (CESIs) decrease inflammation and discomfort in affected patients. CESIs may work differently for different spinal diseases. This study aimed to evaluate the efficacy of caudal epidural steroid injections in managing pain and radiculopathy in patients with LBP and lumbar radiculopathy.

Methods: A cross-sectional retrospective case study was conducted on 40 patients treated with CESIs. Inclusion criteria encompassed adults with LBP and radiculopathy, confirmed by MRI findings such as disc herniation, early spondylitis, spinal canal stenosis, and ligamentum flavum thickening. Pain scores were measured using the Numeric Pain Rating Scale (NPRS) at baseline, 1 week, 1 month, and 3 months post-injection. Data were analyzed using paired t-tests and ANOVA to determine statistical significance.

Results: At baseline, the mean pain score was 8.2, which reduced significantly to 4.8 at 1 week, 3.2 at 1 month, and 2.7 at 3 months post-injection (p < 0.001 for each interval). Improvement in radiculopathy symptoms was observed in 75% of patients by the 3-month follow-up. Patients with disc lesions experienced the greatest symptom improvement (78%, p = 0.02), followed by those with ligamentum flavum thickening and spinal canal stenosis. No serious adverse effects were reported.

Conclusion: Caudal epidural steroid injections effectively reduced pain and radiculopathy symptoms in patients with LBP. The greatest benefit was observed in patients with intervertebral disc lesions, suggesting that MRI findings may help optimize patient selection for this treatment. CESIs were safe, with minimal adverse effects.

Recommendations: Further research with larger sample sizes is recommended to explore long-term outcomes and to refine selection criteria based on MRI findings, enhancing treatment efficacy for specific spinal pathologies.

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