Effectiveness of ultrasonography-guided caudal epidural steroid injection in improving pain and functional status of geriatric patients with spinal pain

Abstract

Introduction: Treatment of lumbar spinal pain in geriatric patients is challenging. This study retrospectively investigated the effects of an ultrasonography-guided caudal epidural steroid injection on pain and functional recovery in geriatric patients (age ≥65 years). Materials and Methods: Fifty-eight patients who received ultrasonography-guided caudal epidural steroid injection between December 2019 and March 2023 were retrospectively evaluated. Pain levels were evaluated using the Visual Analog Scale, and functional recovery was assessed using Oswestry Disability Index. The time points for evaluation were preoperative, immediately post-procedure, and at three weeks and three months post-procedure. Results: The main underlying conditions in this cohort were lumbar spondylosis, lumbar disc herniation, and lumbar spondylolisthesis. Thirty patients had multiple-level lumbar canal narrowing, 13 had L4-5 and L5-S1 disc herniation, and five had lumbar spondylolisthesis. Ten patients had a history of lumbar spinal surgery. Fourteen patients had at least three comorbid conditions (cardiovascular disease, morbid obesity, renal disease, etc.), and six had four comorbid conditions. Pain Visual Analog Scale scores in the immediate postoperative period and at three weeks and three months were significantly lower than the preoperative score (p < 0.001). Oswestry Disability Index scores at three weeks and three months postoperatively were significantly better than the pre-procedure scores (p < 0.001). Conclusions: Ultrasonography-guided caudal epidural steroid injection is an excellent pain management modality in the treatment of spinal pain, especially in the geriatric age group. Keywords: Pain; Steroid; Ultrasonography; Comorbidity.