Treatment of lumbar spinal stenosis with epidural steroid injections: A retrospective outcome study

Objective: To determine patient satisfaction, relief of pain, frequency of injections, change of function, and subsequent surgical rate in patients who received epidural steroid injections (ESIs) for the diagnosis of lumbar spinal stenosis (LSS). Design: Retrospective review conducted using a standard set of questions asked over the telephone, 6 to 36 months after the patient received an ESI. Setting: An outpatient spine center. Participants: One hundred forty patients at or over the age of 55 years diagnosed with LSS who received ESI(s). Intervention: Transforaminal or caudal fluoroscopically guided ESIs with 60 to 100mg of triamcinalone in combination with local anesthetic or normal saline. Main Outcome Measures: Duration and amount of pain relief, change in functional status, patient satisfaction, and surgical rate, assessed by a 5-item questionnaire. Results: Of the 140 participants, 32% reported more than 2 months of pain relief, 39% reported less than 2 months of pain relief, and 29% reported no relief from the injection(s). Twenty percent subsequently had surgery. Fifty-three percent reported improvement in their functional abilities. Seventy-four percent where at least somewhat satisfied with ESI as a form of treatment. Conclusions: ESI is a reasonable treatment for LSS, providing one third of our patient population with sustained relief and more than half with sustained improvement in function.