Shahzad Javed, Naeem Ahmad, Ijaz Ahmad, Amer Aziz.
Role of caudal epidural injection in lumbar disc herniaiton.
J Pak Orthop Assoc Jan ;20(2):98-107.

Objective: The objectives of this study were to determine the efficacy of caudal epidural steroids for lumbar disc herniation and observe any procedural complication. Study Design: Interventional quasi experimental study. Place and duration of study: Department of Orthopaedics and Spinal Surgery, Ghurki Trust Teaching Hospital Lahore. from March 2007 to August 2007. Patients and Methods: Fifty cases fulfilling the inclusion criteria were selected. Efficacy of caudal epidural was determined by improvement in Denis pain scale, Macnab’s criteria and straight leg raising (SLR) improvement was also noted on 2nd and 3rd visits for injection. Results: There were 2 (4%) patients of 2nd and 2 (16.7%) patients on 3rd injection who developed spinal anaesthesia. There was 1 (2%) patient of hypotension on 1st, 6 (12%) patients of 2nd and 3 (25%) patients of 3rd injection. There were 2 (4%) patients of headache on 1st, 4 (8%) patients of 2nd and 2 (16.7%) patients on 3rd injections. There were 6 (12%) patients of paraesthesia on 1st, 8 (16%) patients of 2nd and no patient of 3rd injection. There was no patient of difficulty in voiding on 1st, 1 (2%) patients of 2nd and no patient of 3rd injection. Conclusion: Epidural Steroid Injection is a safe and effective mode of treatment for low back pain in patients with lumbar disc herniation. It provides pain-free period to enable the patient for physiotherapy, which helps in early recovery. The treatment is not only effective clinically but also cost effective.

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