CAUDAL EPIDURAL STEROIDS

OUTCOME IN LUMBER DISC HERNIATION

Abstract

Introduction: About 85% of the population experience low back pain during
adulthood and annual incidence is 5 to 15% with no gender discrimination. Design: Quasi
intervention experimental study. Setting: DHQ teaching Hospital & at Fazil Memorial Hospital
Gujranwala. Period: November 2010 to November 2012 (two years). Material & Methods:
Hundred patient fulfilling the inclusion criteria with SYMPTOMATIC LUMBER DISC herniation
were selected. Efficacy was determined by improvement in Denis Pain scale and Mcnab’s
functional criteria. Safety was determined by absence / rareness of complications i.e spinal
anesthesia, transient hypotension, and paresthesia, difficulty in voiding, infection and
meningitis. Follow up was weekly for 6 weeks Results: Out of hundred cases 53 were gents
and 47 were ladies. Mean age was 37.56 (22-50 yrs). Maximum cases 72% were in third decade
of life. Maximum pain relief was noted after three weeks of first injection, 72% of the cases were
either having no or mild pain. Functional recovery was excellent in 44% and good in 40% of the
patients. Complications were fewer and mild, Spinal anesthesia in 2%, transient hypotension
in 3%. Paresthesia in 8% and 10% of the patient developed supra pubic fullness but only one
needed catheterization. Infection and meningitis was not observed in any case. Conclusions:
Caudal epidural steroids injection is safe & effective mode of treating lumbar disc herniation.