J Korean Pain Soc.  1991 Nov;4(2):162-167.

Epidural Steroid Therapy as a Treatment of Post-laminectomy Low Back Pain

• Choe H
• Han YJ

Abstract

Epidural steroid therapy has been well-established for the treatment of sciatica and low back pain. Disappointing results following surgical decompression or discectomy pain owing for to nerve root compression have led to trials of corticosteroids injected either systemically or into the intrathecal or epidural space to treat intervertebral disc. Epidural steroid is less effective in the patients with low back pain who have a history of surgical operation, so that the use of epidural morphine and methylprednisolone has been advocated for the amelioration of chroaic low back pain in the postlaminectomy pain (failed back) syndrome over the past several years. We treated 47 patients with low back pain who had a history of one or two surgical procedures. We concluded that epidural steroid therapy is less effective in the patients with "failed back" syndrome than in the virgin back furthermore, there is a greater risk of complieation such as inadvertent dural puncture and corresponding motor paralysis and headache.

MeSH Terms

Adrenal Cortex Hormones
Decompression, Surgical
Diskectomy
Epidural Space
Headache
Humans
Intervertebral Disc
Low Back Pain*
Methylprednisolone
Morphine
Paralysis
Punctures
Radiculopathy
Sciatica
Adrenal Cortex Hormones
Methylprednisolone
Morphine