Outcomes of fluoroscopically guided lumbar interlaminar epidural steroid injections in degenerative lumbar scoliosis with spinal stenosis patients

Abstract

© JOURNAL OF THE MEDICAL ASSOCIATION OF THAILAND. Objective: Fluoroscopically guided lumbar epidural steroid injection has been widely used for the treatment of lumbosacral radicular pain. The objectives of this prospective cohort study were to report the short-and long-term outcomes of fluoroscopically guided lumbar interlaminar epidural steroid injection (IESI) in degenerative lumbar scoliosis with spinal stenosis (DLSS) patients. Materials and Methods: The DLSS patients received fluoroscopically guided lumbar IESI with 80 mg of methylprednisolone and 3 ml of 1% lidocaine hydrochloride. Patients were evaluated by an independent observer before the initial injection and at 2-week, 6-week, 3-month, and 12-month after the injections. Visual analog scale (VAS), Roland 5-point pain scale, standing tolerance, walking tolerance, and patient satisfaction scale were evaluated for the outcome measurements. Results: Between February 2010 and January 2012, 35 DLSS patients treated with fluoroscopically guided lumbar IESI were completely followed up for inclusion in the present study. The average number of injections per patient was 1.6 (range from 1 to 3 injections per patient). Significant improvements in VAS and Roland 5-point pain scale were observed over the follow-up period from 2 weeks to 12 months (p<0.05). The standing tolerances were not significantly improved at any of the follow-up time periods post injection (p>0.05). The walking tolerances were significantly improved at 2-week and 6-week for the leg pain predominant (LP) group and at 3-month for the back pain predominant (BP) group (p<0.05). When compared between groups, the walking tolerance of the LP group was more significantly improved than walking tolerance in the BP group (p=0.004). Conclusion: Fluoroscopically guided lumbar IESI improved short-and long-term VAS and Roland 5-point pain scale in DLSS patients. The walking tolerance of the LP group was more significantly improved than walking tolerance in the BP group.