Short-Term Evaluation of the Steroid Epidural Injection Method for Patients with Degenerative Lumbar Stenosis

Pamudji Utomo, R. Andhi Prijosedjati, Haryo Wicaksono
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引用次数: 1

Abstract

Background: Spinal stenosis is a narrowing of the vertebral canal that com-presses spinal nerves and may cause leg pain and difficulty walking. The symptoms of degenerative lumbar stenosis commonly occur in elderly adults and can be treated conservatively with pain-relieving agents or aggressively with decompressive surgery. However, studies on the effectiveness of steroid epidural injection (EPI) on reducing pain in patients with degenerative lumbar stenosis in Indonesia are lacking. This study aimed to evaluate the short-term effect of the steroid epidural injection method on the reduction of pain and disability in patients with degenerative lumbar stenosis. Subjects and Method: This was a cohort study conducted at Prof. Dr. R. Soeharso Orthopedi Hospital, Surakarta, Central Java, from March 2015 to January 2016. A total of 50 patients with degenerative lumbar stenosis was selected for this study. The dependent variables were pain and disability levels. The independent variable was EPI. Pain level was measured by visual analog scale (VAS). Disability level was measured by Oswestri Disability Index (ODI). The outcome data before and after the intervention (EPI) were compared by t-test. Results: Score of VAS a month after EPI (mean= 36.20) was lower than before EPI (mean= 63.20) and it was statistically significant (p= 0.027). Score of ODI a month after EPI (mean= 42.82) was lower than before EPI (mean= 54.90) and it was statistically significant (p= 0.033). However, scores of both VAS and ODI began to rise three months after EPI. Conclusion: Non-operative steroid epidural injection (EPI) is effective to reduce pain and disability among patients with degenerative lumbar stenosis in the short-term within three months after the intervention. Keywords: steroid epidural injection, pain, disability, degenerative lumbar stenosis.
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硬膜外注射类固醇治疗退行性腰椎管狭窄症的短期疗效评价
背景:椎管狭窄是一种椎管狭窄,压迫脊神经,可引起腿部疼痛和行走困难。退行性腰椎管狭窄症的症状通常发生在老年人身上,可以保守地使用止痛药或积极地进行减压手术治疗。然而,在印度尼西亚,关于硬膜外注射类固醇(EPI)减轻退行性腰椎管狭窄患者疼痛的有效性的研究缺乏。本研究旨在评估类固醇硬膜外注射方法在减轻退行性腰椎管狭窄患者疼痛和残疾方面的短期效果。对象和方法:这是一项队列研究,于2015年3月至2016年1月在中爪哇苏拉卡塔的R. Soeharso骨科医院进行。本研究共选择了50例退行性腰椎管狭窄症患者。因变量为疼痛和残疾水平。自变量为EPI。采用视觉模拟评分法(VAS)测量疼痛程度。用Oswestri残疾指数(ODI)衡量残疾水平。干预前后结局数据(EPI)采用t检验比较。结果:EPI后1个月VAS评分(平均36.20分)低于EPI前(平均63.20分),差异有统计学意义(p= 0.027)。EPI后1个月ODI得分(平均42.82分)低于EPI前(平均54.90分),差异有统计学意义(p= 0.033)。然而,在EPI后3个月,VAS和ODI的评分开始上升。结论:非手术类固醇硬膜外注射(EPI)在干预后3个月内可有效减轻退行性腰椎管狭窄症患者的短期疼痛和残疾。关键词:硬膜外类固醇注射,疼痛,残疾,退行性腰椎管狭窄。
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