Comparison the effect of epidural steroid injection by Caudal and Lumbar methods for controlling the radicular pain of lower extremity

 Aims and background: Chronic low back pain is one of the common causes of patients referring to specialized and general medical clinics. The positive effect of Epidural Steroid injection has been proven in relieving pain in these patients. In this study, the epidural effects of methylprednisolone acetate in these two methods of Caudal and Lumbar were compared. Materials and Methods: In this study, 80 patients with radicular lower limb pain due to lumbar intervertebral disc protrusion who were referred to the pain clinic were divided into two groups of 40 patients. In the first group, steroids were injected into the epidural site by Lumbar method and in the second group by Caudal method. The effects of these two methods on reducing patients’ pain at 2-month intervals and at the end of 1 year were evaluated and compared. Results: According to this study, epidural steroid injection significantly reduced the mh pain in patients (P <0.001), but there was significant difference between Lumbar and Caudal methods. There was no reduction in pain. The rate of pain reduction in patients one year after epidural steroid injection in both lumbar and Caudal methods was not related to the level of discopathy. The rate of pain reduction after lumbar epidural steroid injection in patients with a history of lumbar spine surgery was less than caudal injection (P = 0.043). In Patients with a history of lumbar spine surgery the injection of caudal steroid would further reduce their pain (P = 0.336). Epidural steroid injection improves deep tendon reflexes (DTR) anesthesia of the lower extremities Conclusion: Patients with radicular pain in the lower extremities who have not responded well to medication can benefit from epidural steroid injections. In reviewing the results of one year, the lumbar or caudal injection method is not preferable to another. Only in cases where the patient has a history of lumbar spine surgery, the caudal method will be preferred.