SYMPTOMS OF SPINAL STENOSIS DO NOT IMPROVE AFTER EPIDURAL STEROID INJECTION

Objective: This study was carried out to evaluate the therapeutic effe ct of epidural steroid injection on pseudoclaudication in patients wit h lumbar degenerative spinal canal stenosis. Design: Fifty-three patie nts who complained of pseudoclaudication of less than 20 m in walking distance were randomly divided into three groups. Group 1 (n = 16) und erwent epidural injection with 8 ml of saline. Group 2 (n = 18) underw ent epidural block with 8 ml of 1% mepivacaine. Group 3 (n = 19) under went epidural block with a combination of 8 ml of 1% mepivacaine and 4 0 mg of methylprednisolone. The criteria of evaluation were as follows : excellent effect, >100 m in walking distance; good effect, 20-100 m in walking distance; poor effect, <20 m in walking distance. Results: In group 1, the numbers of patients who showed a good effect were two (12.5%) after 1 week, one (6.5%) after 1 month, and one (6.5%) after 3 months. In group 2, the numbers of patients who showed a good or exce llent result were 10 (55.5%) after 1 week, three (16.7%) after 1 month , and one (5.6%) after 3 months. In group 3, the numbers of patients w ho showed a good or excellent result were 12 (63.2%) after 1 week, thr ee (15.8%) after 1 month, and one (5.3%) after 3 months. There was no significant difference in the effectiveness of treatment between group 2 and group 3 throughout the time course. Conclusion: The results sug gest that epidural steroid injection has no beneficial effect on the p seudoclaudication associated with spinal canal stenosis as compared wi th epidural block with a local anesthetic alone.