Skeletal Radiology

, Volume 39, Issue 7, pp 691–699

Fluoroscopically guided caudal epidural steroid injection for management of degenerative lumbar spinal stenosis: short-term and long-term results

  • Joon Woo Lee
  • Jae Sung Myung
  • Kun Woo Park
  • Jin S. Yeom
  • Ki-Jeong Kim
  • Hyun-Jib Kim
  • Heung Sik Kang
Scientific Article

DOI: 10.1007/s00256-009-0860-1

Cite this article as:
Lee, J.W., Myung, J.S., Park, K.W. et al. Skeletal Radiol (2010) 39: 691. doi:10.1007/s00256-009-0860-1

Abstract

Objective

To evaluate the short-term and long-term effects of fluoroscopically guided caudal epidural steroid injection (ESI) for the management of degenerative lumbar spinal stenosis (DLSS) and to analyze outcome predictors.

Materials and methods

All patients who underwent caudal ESI in 2006 for DLSS were included in the study. Response was based on chart documentation (aggravated, no change, slightly improved, much improved, no pain). In June 2009 telephone interviews were conducted, using formatted questions including the North American Spine Society (NASS) patient satisfaction scale. For short-term and long-term effects, age difference was evaluated by the Mann–Whitney U test, and gender, duration of symptoms, level of DLSS, spondylolisthesis, and previous operations were evaluated by Fisher’s exact test.

Results

Two hundred and sixteen patients (male:female = 75:141; mean age 69.2 years; range 48 ∼ 91 years) were included in the study. Improvements (slightly improved, much improved, no pain) were seen in 185 patients (85.6%) after an initial caudal ESI and in 189 patients (87.5%) after a series of caudal ESIs. Half of the patients (89/179, 49.8%) replied positively to the NASS patient satisfaction scale (1 or 2). There were no significant outcome predictors for either the short-term or the long-term responses.

Conclusion

Fluoroscopically guided caudal ESI was effective for the management of DLSS (especially central canal stenosis) with excellent short-term and good long-term results, without significant outcome predictors.

Keywords

Caudal epidural steroid injectionSpine interventionLumbar spineSpinal stenosisSteroid

Copyright information

© ISS 2009

Authors and Affiliations

  • Joon Woo Lee
    • 1
  • Jae Sung Myung
    • 1
  • Kun Woo Park
    • 2
  • Jin S. Yeom
    • 2
  • Ki-Jeong Kim
    • 3
  • Hyun-Jib Kim
    • 3
  • Heung Sik Kang
    • 1
  1. 1.Department of RadiologySeoul National University Bundang HospitalSeong NamKorea
  2. 2.Department of Orthopaedic SurgerySeoul National University Bundang HospitalSeong NamKorea
  3. 3.Department of NeurosurgerySeoul National University Bundang HospitalSeong NamKorea