Effectiveness of Bilateral Transforaminal Epidural Steroid Injections in Degenerative Lumbar Spinal Stenosis Sufferers With Neurogenic Claudication: A Case Sequence.
PM R. 2017 Jan;9(1):26-31
Authors: Farooque M, Salzman MM, Ye Z
BACKGROUND: As our inhabitants ages, neurogenic claudication (NC) from central canal stenosis of the lumbar backbone is changing into an more and more widespread situation. Research have been undertaken to evaluate the efficacy of caudal, interlaminar, or unilateral transforaminal epidural injections, however bilateral transforaminal epidural injections (BTESIs) haven’t been evaluated to this point.
OBJECTIVE: To evaluate the therapeutic worth and long-term results of fluoroscope-guided BTESIs in sufferers with NC from degenerative lumbar spinal stenosis (DLSS) of the central spinal canal.
DESIGN: Case sequence.
SETTING: Single establishment backbone clinic.
PATIENTS: Twenty-six adults between the ages of 40 and 90 years with a prognosis of DLSS and a historical past of subacute or continual NC.
METHODS/INTERVENTIONS: Sufferers assembly inclusion standards acquired fluoroscope-guided BTESI of native anesthetic and steroid on the stage instantly beneath probably the most stenotic stage. Affected person self-reported ache stage, exercise stage, and total satisfaction had been recorded by phone interview at 1, three, and 6 months after injection by an impartial observer.
MAIN OUTCOME MEASURES: Ache rating and Swiss Spinal Stenosis rating at baseline, 1, three, and 6 months.
RESULTS: Of the 22 contributors eligible for evaluation, 20, 19, and 18 had follow-up information accessible at 1, three, and 6 months, respectively. Discount in numeric ache scale rating of no less than 50% was famous in 30% of contributors at 1 month, 53% at three months, and 44% at 6 months. Swiss Spinal Stenosis subscale scores indicated a major discount within the proportion of contributors reporting the presence of extreme ache within the again, buttocks, and legs (significantly the again or buttocks) at 1, three, and 6 months of follow-up in contrast with baseline (P < .05). The proportion of contributors reporting extreme weak point within the legs or toes additionally decreased after injection and was statistically important at three months of follow-up (P = .04).
CONCLUSIONS: Fluoroscope-guided BTESI was reasonably efficient in lowering ache, enhancing perform, and reaching affected person satisfaction in sufferers with NC from DLSS on the central spinal canal on this medical case sequence.
LEVEL OF EVIDENCE: IV.
PMID: 27292437 [PubMed – indexed for MEDLINE]