Background & Aims
Back pain is the leading cause of disability worldwide, with annual prevalence of 15% to 45%. Patients suffering from low backache has to face great social, economic and health impact including pain related disability causing depression and occupational dysfunction effecting their quality of life.
Chronic low backache arises from different etiologies but mainly it exhibits a radicular component, involving herniating disc and spinal stenosis. Disc herniation in patients with chronic low backache is very high and has been reported to be near 40% it involves the extrusion of disc material from the nucleus pulposus beyond the limits of intervertebral disc space resulting in the inflammatory mediators spread near the spinal nerve roots, causing a combination of chemical and mechanical factors that irritate the adjacent exposed nerve roots and cause radiating pain which is tingling, burning or electrical in nature. Almost 95% of all disc herniation occurs in the lumbar spine at L4-5,L5S1
Methods
We divide the patients in two groups and did studybthe outcomes like, pain score, disability index and anxiety using different questionnaire, two groups were transforaminal epidural steroid injection plus caudal epidural steroid injection with catheter versus transforaminal epidural steroid injection plus lumbar interlaminar epidural steroid injection in patients having low backache with radiculopathy or radicular pain
We gave the same dose of the steroids but with different techniques in OR under the image
Results
Transforaminal epidural steroidninjection plus caudal epidural steroid injection with catheter group was having much better response and it was more pain free and good score reduction in Oswestry index and Hamilton anxiety score was also reduced and overall good patient satisfaction
Conclusions
It’s wise to use transforaminal epidural steroid injection plus caudal epidural steroid injection with catheter for the patients coming with radicular lowbackache or with radiculopathy, because it gives more patient satisfaction in pain score and disability index as well as in terms of anxiety.
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Transforaminal vs Caudal Epidural Steroid Injections
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Presenting Author
Hamza waheed
Poster Authors
Hamza Waheed
FCPS Anesthesia, pain medicine
Naas general hospital, ireland
Lead Author
Topics
- Specific Pain Conditions/Pain in Specific Populations: Low Back Pain