COMPARISON OF LUMBAR INTERLAMINAR EPIDURAL STEROID VERSUS CAUDAL EPIDURAL STEROID IN TREATMENT OF LUMBAR SPINAL STENOSIS

SY KHAN; M AKRAM

doi:10.54112/pjicm.v5i02.156

Authors

SY KHAN Department of Trauma and Orthopedics, Mayo Hospital Lahore, Pakistan
M AKRAM Department of Trauma and Orthopedics, Mayo Hospital Lahore, Pakistan

DOI:

https://doi.org/10.54112/pjicm.v5i02.156

Keywords:

Lumbar Spinal Stenosis, Epidural Steroid Injection, Interlaminar Approach, Caudal Approach, Oswestry Disability Index, Numeric Pain Rating Scale

Abstract

Background: Lumbar spinal stenosis (LSS) is a common cause of low back pain and disability in adults. Epidural steroid injections are frequently used for symptomatic relief, but the optimal approach remains debated. Objective: To compare clinical outcomes between caudal and interlaminar epidural steroid injections in patients with lumbar spinal stenosis. Study Design: Randomized controlled trial. Setting: Orthopedic Unit I, Mayo Hospital, Lahore, Pakistan. Duration of Study: 02-March-2024 to 02-September-2024. Methods: A total of 416 patients with clinically and radiologically confirmed LSS (Lee Grade 1–3 on MRI) were randomly allocated into two groups. Group A received fluoroscopically-guided interlaminar epidural steroid injections at the L2–L3 level, while Group B received fluoroscopically-guided caudal epidural steroid injections. The Oswestry Disability Index (ODI) and Numeric Pain Rating Scale (NPRS) were assessed at baseline and at 12 weeks post-intervention. Results: At the 12-week follow-up, Group A demonstrated significantly lower mean NPRS scores (2.65 ± 1.084) compared to Group B (3.25 ± 1.332; p = 0.0001). Functional improvement was also greater in Group A, with a lower mean ODI score (13.97 ± 2.045) versus Group B (15.91 ± 3.277; p = 0.0001). Conclusion: Interlaminar epidural steroid injection provided superior pain relief and functional improvement compared to caudal epidural steroid injection in patients with lumbar spinal stenosis.

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