Ann Rehabil Med.  2016 Feb;40(1):14-20. 10.5535/arm.2016.40.1.14.

The Effect and Safety of Steroid Injection in Lumbar Spinal Stenosis: With or Without Local Anesthetics

• Song SH
• Ryu GH
• Park JW
• Lee HJ
• Nam KY
• Kim H
• Kim SY
• Kwon BS

• KMID: 2155160
• DOI: http://doi.org/10.5535/arm.2016.40.1.14

Abstract

OBJECTIVE
To compare the long-term effect and safety of an epidural steroid injection in spinal stenosis patients, with or without local anesthetics.
METHODS
Twenty-nine patients diagnosed with spinal stenosis were included and randomly divided into two groups. Translaminar epidural and selective nerve root spinal injection procedures were performed using steroids mixed with local anesthetics or normal saline. The effects of spinal injection procedures were measured with visual analogue scale (VAS) and functional rate index (FRI). These measurements were performed before injection, at 1 month after injection and at 3 months after injection. The occurrence of side effects was investigated each time.
RESULTS
The VAS and FRI scores were significantly reduced in both the local anesthetics group and normal saline group at 1 and 3 months after the injection. However, there was no significant difference in VAS and FRI score reduction between the two groups each time. Side effects are not noted in both groups.
CONCLUSION
The spinal injection procedures using steroids mixed either with local anesthetics or normal saline have an effect in reducing pain and improving functional activities. However, there was no significant difference between the two groups in relation to side effects and the long-term effects of pain and function.

Keyword

Epidural injections; Spinal stenosis; Steroids; Anesthetics

MeSH Terms

Anesthetics
Anesthetics, Local*
Humans
Injections, Epidural
Injections, Spinal
Spinal Stenosis*
Steroids
Anesthetics
Anesthetics, Local
Steroids

Figure

• 

  Fig. 1 Flow chart of study design. Fifty-three patients were screened for this study. Twenty-nine patients participated, and were divided randomly into two groups. There was no follow-up loss in both groups.

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  Fig. 2 Trend of visual analogue scale (VAS) score in lidocaine and saline groups. Trend of VAS score in the two groups before injection, and at 1 and 3 months after injection. Compared with the initial VAS score, both groups showed a significant reduction in VAS score at 1 month and 3 months after injection (*p<0.05). A significant difference in VAS reduction was not noted between the two groups.

• 

  Fig. 3 Trend of functional rate index (FRI) score in lidocaine and saline groups. Trend of FRI score in two groups before injection, and at 1 and 3 months after injection. Compared with the initial FRI score, both groups showed a significant reduction in FRI score at 1 month and 3 months after injection (*p<0.05). There was no significant difference in FRI score reduction between the two groups.

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