Role of psoas compartment and caudal epidural steroid injection in spinal stenosis patients associated with low back pain and lower limb radiculopathy.

OBJECTIVE: To study the efficacy, safety and patient satisfaction of psoas compartment and caudal epidural steroid injection in patients with spinal stenosis and lumbosaccral radiculopathy.

METHODS: Patients with a diagnosis of spinal stenosis and lumbosaccral radiculopathy having visual analogue score (VAS) less than five were included in the study. Bilateral psoas compartment and caudal epidural injection was given to all patients. In group-A patients haemodynamics and complications were examined immediately after injection. In group-B the same patients were examined through a questionnaire after eight weeks, for pain relief, duration of pain relief, reduction in painkillers and overall improvement in activities of daily living.

RESULTS: Total 106 patients were examined. In group-A change in haemodynamics before and after twenty minutes of injection was less than 15 percent and no immediate complications were reported. In group B more than 90 percent of patients reported relief of pain and VAS remained below three. Relief of pain lasted for 1-2 weeks, 2-4 weeks, 4-6 weeks and 6-8 weeks in 13 percent, 11 percent, 27 percent and 43 percent of patients respectively. More than fifty percent of patients reported up to 70 percent improvement in activities of daily living (ADL) and reduction in weekly intake of supplemental pain killers. Six percent of the (seven) patients reported no response to treatment.

CONCLUSION: Psoas compartment and caudal epidural steroid injection could be an alternate option for pain relief in patients with spinal stenosis and lumbosaccral radiculopathy.