Efficacy of epidural steroid injections and evaluation of surgical and anesthetic approaches in far-lateral disc herniations

Aim: To observe the long-term effect of epidural steroid injections (ESI) and describe surgical outcomes in patients with far-lateral lumbar disc herniations. Materials & methods: The medical records of 30 patients who underwent surgery for far-lateral lumbar disc herniations were reviewed. Results: ESI outcomes: pain scores decreased significantly after ESI (p = 0.004). The surgery was delayed for 13.78 +/- 8.59 months in patients who received ESI. Surgical outcomes: the improvement in the leg pain was considerably more significant than the back pain (p < 0.001). While motor deficit improved substantially (p < 0.001), there was persistent sensory dysesthesia. Conclusion: ESI does not prevent but may delay the surgery up to 28 months. Although postoperative pain scores were significantly decreased, there was persistent back pain and sensory paresthesia. Plain language summaryFar-lateral lumbar disc herniation is a rare condition, and it constitutes a specific group of lumbar disc hernias regarding its anatomic location. It causes far more severe and intractable back and leg pain than the other widely known group of disc hernias. Sometimes, it can lead to sensation disorders and even functional impairment in the legs. Few can benefit from conservative treatments, including painkillers and physical therapy so surgical treatment becomes inevitable in many patients. Lumbar steroid injections to the epidural space may provide significant symptom relief and delay surgery in certain patients.

Automated summary

This study aimed to observe the long-term effect of epidural steroid injections (ESI) and describe surgical outcomes in patients with far-lateral lumbar disc herniations. The medical records of 30 patients who underwent surgery for far-lateral lumbar disc herniations were reviewed. The results showed that ESI can provide significant pain relief and delay the need for surgery, but persistent back pain and sensory abnormalities may still exist.