What is the efficacy of lumbar caudal epidural steroid injections (ESIs)?

Updated: Aug 06, 2018
  • Author: Boqing Chen, MD, PhD; Chief Editor: Stephen Kishner, MD, MHA  more...
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Answer

Answer

Results from studies on caudal epidural injections are as follows:

  • Barre and colleagues reported that in 35% of patients with symptomatic lumbar spinal stenosis who received caudal ESIs, a visual numeric score improvement of 50% or greater was seen. [7] Long-term treatment success was seen in 35% of patients after a mean follow-up of 32 months.

  • Anwar and coauthors demonstrated that caudal injections could benefit patients with limited straight leg raise and symptoms of radicular pain or spinal stenosis; in this study, 65% of patients were noted to have some improvement at 3 months.

  • A systematic appraisal of the literature on caudal epidural steroid injections included 11 randomized trials and 5 nonrandomized studies. This study concluded that for lumbar disk herniation, the efficacy is good for short- and long-term relief of chronic pain secondary to disk herniation or radiculitis with local anesthetic and steroids and is fair with local anesthetic only. In managing chronic axial or diskogenic pain, spinal stenosis, and postsurgery syndrome, the indicated evidence is fair. [8]


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