COMPARISON OF THE EFFECTIVENESS BETWEEN FLUOROSCOPY GUIDED TRANSFORAMINAL EPIDURAL AND CAUDAL EPIDURAL DEXAMETHASONE INJECTION IN THE REDUCTION OF PAIN AND DISABILITY IN POST LAMINECTOMY SYNDROME: A RANDOMIZED CONTROLLED TRIAL

Chandrakant Pilania, Longjam Nilachandra Singh, Akoijam Joy Singh, Yumnam Ningthemba Singh, Margaret Chabungbam, Moirangthem Janet, Sreejith C, Tasso Opo, Monica Moirangthem

Abstract


Low back pain is a highly prevalent, worldwide problem and is a very frequent reason for medical consultations. Epidural fibrosis is a complication of laminectomy surgery done for low back pain. Use of epidural steroid injections has been shown to decrease the frequency and intensity of the pain in post laminectomy syndrome.

In this study, 24 patients from Manipur, who were diagnosed as post-laminectomy syndrome with epidural fibrosis on magnetic resonance imaging (MRI) were randomly assigned into 2 equal groups. Group A (caudal epidural) and group B (transforaminal epidural). Both groups were injected dexamethasone injection and outcomes measured by using Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) and compared base line with outcomes at 1, 4 and 8 weeks

In this study both fluoroscopy guided caudal epidural and transforaminal epidural dexamethasone injections are effective in reducing pain and functional disability in post laminectomy syndrome.

However, transforaminal epidural injection is better than caudal epidural. High concentration of steroid in the target site accounts for the result.

 


Keywords


Low Back Pain, Post Laminectomy Syndrome, Caudal Epidural, Dexamethasone, Hiatus, Oswestery Disability Index

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References


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