Comparative evaluation of caudal epidural, interlaminar, and transforaminal epidural steroid injection in patients with lumbar spinal canal stenosis
Background: Lumbar spinal stenosis (LSS) is a common degenerative spinal condition which is a major cause of pain and functional disability. Epidural steroid injections with or without local anesthetics have been used for the treatment of spinal pain, particularly for radicular symptoms and spinal s...
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Manipal College of Medical Sciences, Pokhara
2025-03-01
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| Series: | Asian Journal of Medical Sciences |
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| Online Access: | https://ajmsjournal.info/index.php/AJMS/article/view/4320 |
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| author | Jyotsna Amit Kumar Anshul Naveen Malhotra Navya Malhotra Ritwik Gupta |
| author_facet | Jyotsna Amit Kumar Anshul Naveen Malhotra Navya Malhotra Ritwik Gupta |
| author_sort | Jyotsna |
| collection | DOAJ |
| description | Background: Lumbar spinal stenosis (LSS) is a common degenerative spinal condition which is a major cause of pain and functional disability. Epidural steroid injections with or without local anesthetics have been used for the treatment of spinal pain, particularly for radicular symptoms and spinal stenosis.
Aims and Objectives: The primary objective was to compare the efficacy of the three routes in terms of improvement in pain, disability and patient satisfaction. Secondary objectives were to compare the requirement for repeat injections and side effects, if any.
Materials and Methods: In this prospective, randomized study, 90 patients with medical evaluation and pain pattern consistent with a diagnosis of LSS were randomized into three groups: Group-I (n=30) patients were administered caudal epidural steroid injection; Group-II (n=30) interlaminar epidural steroid injection; and Group-III (n=30) transforaminal epidural steroid injection (TFESI). The primary objective was to compare the efficacy of the three routes in terms of improvement in pain, disability, and patient satisfaction. Secondary objectives were to compare the requirement for repeat injections and side effects, if any.
Results: There was a statistically significant improvement in pain score, Oswestry disability index (ODI) score, and Swiss spinal stenosis questionnaire (SSSQ) score in all groups at all study periods. (P<0.01) The pain scores and SSSQ scores were clinically and statistically significantly lower after TFESI as compared to other groups from 1 month onward after the injection at all study interval periods (P<0.01), whereas ODI scores were better from 3 months onward.
Conclusion: All three techniques provide good pain relief and improvement in disability to the patients. TFESI is better than other two techniques in terms of improvement in pain score, treatment outcome, and functional disability. |
| format | Article |
| id | doaj-art-e8a992ebb0724c95a3044581ae78d2af |
| institution | OA Journals |
| issn | 2467-9100 2091-0576 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Manipal College of Medical Sciences, Pokhara |
| record_format | Article |
| series | Asian Journal of Medical Sciences |
| spelling | doaj-art-e8a992ebb0724c95a3044581ae78d2af2025-08-20T02:00:33ZengManipal College of Medical Sciences, PokharaAsian Journal of Medical Sciences2467-91002091-05762025-03-01163914https://doi.org/10.71152/ajms.v16i3.4320Comparative evaluation of caudal epidural, interlaminar, and transforaminal epidural steroid injection in patients with lumbar spinal canal stenosisJyotsna 0https://orcid.org/0009-0004-8427-7775Amit Kumar 1https://orcid.org/0000-0001-6421-0152Anshul 2https://orcid.org/0000-0001-8362-3243Naveen Malhotra 3https://orcid.org/0000-0002-5427-2170Navya Malhotra 4https://orcid.org/0009-0007-0214-260XRitwik Gupta 5https://orcid.org/0009-0006-9938-9897Ex Resident, Department of Anaesthesiology and Critical Care, Pt. B.D. Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India Former Senior Resident, Department of Cardiac Anaesthesia and Pain Management Centre, Pt. B.D. Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India Associate Professor, Department of Anaesthesiology and Critical Care, Pt. B.D. Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India Former Senior Resident, Department of Cardiac Anaesthesia and Pain Management Centre, Pt. B.D. Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India MBBS Student, Hamdard Institute of Medical Sciences and Research, New Delhi, India MBBS Student, Hamdard Institute of Medical Sciences and Research, New Delhi, India Background: Lumbar spinal stenosis (LSS) is a common degenerative spinal condition which is a major cause of pain and functional disability. Epidural steroid injections with or without local anesthetics have been used for the treatment of spinal pain, particularly for radicular symptoms and spinal stenosis. Aims and Objectives: The primary objective was to compare the efficacy of the three routes in terms of improvement in pain, disability and patient satisfaction. Secondary objectives were to compare the requirement for repeat injections and side effects, if any. Materials and Methods: In this prospective, randomized study, 90 patients with medical evaluation and pain pattern consistent with a diagnosis of LSS were randomized into three groups: Group-I (n=30) patients were administered caudal epidural steroid injection; Group-II (n=30) interlaminar epidural steroid injection; and Group-III (n=30) transforaminal epidural steroid injection (TFESI). The primary objective was to compare the efficacy of the three routes in terms of improvement in pain, disability, and patient satisfaction. Secondary objectives were to compare the requirement for repeat injections and side effects, if any. Results: There was a statistically significant improvement in pain score, Oswestry disability index (ODI) score, and Swiss spinal stenosis questionnaire (SSSQ) score in all groups at all study periods. (P<0.01) The pain scores and SSSQ scores were clinically and statistically significantly lower after TFESI as compared to other groups from 1 month onward after the injection at all study interval periods (P<0.01), whereas ODI scores were better from 3 months onward. Conclusion: All three techniques provide good pain relief and improvement in disability to the patients. TFESI is better than other two techniques in terms of improvement in pain score, treatment outcome, and functional disability.https://ajmsjournal.info/index.php/AJMS/article/view/4320spinal canal stenosis; transforaminal injectioninterlaminar; caudal epidural injection; oswestry disability index |
| spellingShingle | Jyotsna Amit Kumar Anshul Naveen Malhotra Navya Malhotra Ritwik Gupta Comparative evaluation of caudal epidural, interlaminar, and transforaminal epidural steroid injection in patients with lumbar spinal canal stenosis Asian Journal of Medical Sciences spinal canal stenosis; transforaminal injection interlaminar; caudal epidural injection; oswestry disability index |
| title | Comparative evaluation of caudal epidural, interlaminar, and transforaminal epidural steroid injection in patients with lumbar spinal canal stenosis |
| title_full | Comparative evaluation of caudal epidural, interlaminar, and transforaminal epidural steroid injection in patients with lumbar spinal canal stenosis |
| title_fullStr | Comparative evaluation of caudal epidural, interlaminar, and transforaminal epidural steroid injection in patients with lumbar spinal canal stenosis |
| title_full_unstemmed | Comparative evaluation of caudal epidural, interlaminar, and transforaminal epidural steroid injection in patients with lumbar spinal canal stenosis |
| title_short | Comparative evaluation of caudal epidural, interlaminar, and transforaminal epidural steroid injection in patients with lumbar spinal canal stenosis |
| title_sort | comparative evaluation of caudal epidural interlaminar and transforaminal epidural steroid injection in patients with lumbar spinal canal stenosis |
| topic | spinal canal stenosis; transforaminal injection interlaminar; caudal epidural injection; oswestry disability index |
| url | https://ajmsjournal.info/index.php/AJMS/article/view/4320 |
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