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KMID : 0361620220570050377
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Journal of the Korean Orthopaedic Association
2022 Volume.57 No. 5 p.377 ~ p.384
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Comparison of the Effectiveness of Caudal Epidural Injection and Selective Nerve Root Block in Lumbar Herniated Disk or Spinal Stenosis
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Kim Tae-Kyun
Park Byung-Ha
Kang Sung-Ju
Nam Dae-Jin
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Abstract
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Purpose: This study sought to compare the effectiveness of caudal epidural steroid injections (CESI) and selective nerve root blocks (SNRB) in the treatment of a herniated intervertebral disc (HIVD) or spinal stenosis (SS).
Materials and Methods: This retrospective study conducted from March 2017 to December 2018 included 128 patients who had been diagnosed with single-level HIVD (L3/4, L4/5, L5/S1) or SS with radicular pain over 3 months. Of these, 56 patients who had been diagnosed with single-level HIVD were in group A which was subdivided into group A1, undergoing CESI treatment (28 patients), and group A2, undergoing SNRB treatment (28 patients).The remaining 72 patients diagnosed with SS were in group B, and also subdivided into group B1, on CESI (36 patients), and group B2, on SNRB (36 patients). The visual analogue scale (VAS) pain scores and the Oswestry Disability Index (ODI) of different approaches were compared at pre-injection, 24 hours, 1 week, and 3 months after injection.
Results: All the groups A1, A2, B1, and B2 showed significant improvements in their VAS scores and ODI at 24 hours, 1 week, and 3 months after the procedure. When comparing the A1 and A2 groups and the B1 and B2 groups, the VAS scores and ODI at 24 hours and 1 week after the procedure showed a significant improvement in the A2 and B2 groups, who were treated with SNRB. When comparing the A1 and B1 groups and the A2 and B2 groups, the VAS scores at 24 hours and 1 week after the procedure also showed significant improvements in the B2 group, who were treated with SNRB.
Conclusion: Both CESI and SNRB were effective in single-level HIVD and SS patients. Specifically, the effectiveness of SNRB was more prominent in the SS patients when compared with the HIVD patients. It can be considered that anatomically and pathologically, SNRB showed superior results by resolving the pathology of the posterior structure of SS.
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KEYWORD
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intervertebral disc herniation, spinal stenosis, caudal epidural steroid injection, selective nerve root block
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