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2017, Number 1

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Revista Cubana de Ortopedia y Traumatología 2017; 31 (1)

Epidural infiltration of steroids in the treatment of root pain in the occupation context

Contreras CY, Sánchez HR, Asenjo SJJ, Varillas DD, Ruíz CG, Bernaldo QRS, García LF

Language: Spanish
References: 30
Page: 38-49
PDF size: 208.49 Kb.


ABSTRACT

Introduction: Sciatic pain is a type of pain in the lower extremity that usually follows a specific metameric distribution. The compression or irritation of the sciatic nerve is often the cause, commonly due to lumbar disc herniation. It is one of the most common reasons for consultation in spinal surgery units.
Objective: Determine if epidural steroid infiltrations can improve symptoms in patients with a herniated disc, thus avoiding surgery, which allows them to return to work soon.
Method: We recruited 71 patients with a herniated disc, with a history of sciatic pain of at least 3 months. Patients received a maximum of three epidural infiltrations of steroids given 2 weeks apart, followed by a rehabilitation program.
Results: Out of the 71 patients, 71.8% had L5-S1 disc hernia, 87% were men, mean age was 40.2 years and 57.7% had jobs associated with high functional demands. The average number of weeks off from work was 16.63. At one year, 63.4% of patients were discharged and 36.6% required surgery because of persistent pain despite treatment with epidural steroid injections. The Oswestry disability index and Visual Analog Scale (VAS) reflected a statistically significant improvement (p <0.001) after infiltrations in most cases.
Conclusions: In our context, the administration of epidural steroid infiltrations in patients with secondary radicular pain with a herniated disc is a minimally invasive and effective procedure that alleviates pain, reduces disability and allows a quick return to work activity.


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