J Korean Radiol Soc.  2007 Sep;57(3):281-286. 10.3348/jkrs.2007.57.3.281.

Therapeutic Effect of Epidural Steroid Injection in Patients Suspected of having an Internal Disc Disruption: A Prospective Case Study

• Kim NR
• Lee JW
• Chung SK
• Kim KJ
• Kim HJ
• Kim YJ
• Lee SH
• Hong SH
• Choi JY
• Kang HS

• KMID: 1834500
• DOI: http://doi.org/10.3348/jkrs.2007.57.3.281

Abstract

PURPOSE
To assess the effect of the epidural steroid injection for patients suspected of having an internal disc disruption.
MATERIALS AND METHODS
Thirteen patients at the pain intervention clinic that received a lumbar interlaminar epidural steroid injection and were suspected of having an internal disc disruption were prospectively enrolled in this study. The treatment outcome was assessed using a 5-point patient satisfaction scale (no pain, much improved, slightly improved, no effect, aggravated) two weeks after injection. A successful outcome required a patient satisfaction scale of "much improved" or "no pain". All patients received follow-up for two months. Two radiologists evaluated the presence of HIZ (high intensity zone), a dark disc by MR (n = 10) and a diffuse bulging disc by CT (n = 3).
RESULTS
Nine (69%) of the 13 patients achieved a successful outcome two weeks after injection. These nine patients showed no recurrence during the two months months follow-up. Of the 22 abnormal discs demonstrated by MRI and CT, MRI showed a dark disc in six patients and HIZ in 13 patients. CT showed diffuse bulging in three discs. Nine of 10 patients showed at least one HIZ.
CONCLUSION
An lumbar interlaminar epidural steroid injection might be an effective tool for managing patients suspected of having an internal disc disruption.

Keyword

Spine, intervertebral disk; Radiology, interventional; Steroids, drug therapy

MeSH Terms

Follow-Up Studies
Humans
Magnetic Resonance Imaging
Patient Satisfaction
Prospective Studies*
Radiology, Interventional
Recurrence
Treatment Outcome