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Study: Epidural injections should be used sparingly for spinal stenosis
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In a study of the use of epidural injections for patients with spinal stenosis, researchers concluded the treatment should be used sparingly, if at all, because its long-term effects are not yet proven.
Researchers analyzed the results of the Lumbar Epidural Steroid Injections for Spinal Stenosis (LESS) trial. The randomized, controlled, double-blind study — results of which were published in the New England Journal of Medicine — compared the results epidural injection of glucocorticoids plus lidocaine in 200 patients with lidocaine only in 200 patients for the treatment of spinal stenosis.
All patients were at least 50 years old, had evidence of central lumbar spinal stenosis on MRI or CT scan.
At 3 weeks, patients in the glucocorticoid plus lidocaine showed small improvement in Roland-Morris Disability Questionnaire and pain scores compared with the lidocaine only group; however, the benefit was not observed at the 6-week time point, according to the researchers.
Although patients in both groups demonstrated symptomatic improvement by 6 weeks after injection, the researchers found no significant differences in the degree of improvement between the groups.
The researchers concluded that the trial provided insight into the effectiveness of the management of spinal stenosis, but also that in most cases, epidural steroid injections were not effective long term, unlike spinal decompression surgery.
Disclosure: The authors have no relevant financial disclosures.
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