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Most patient characteristics did not predict results after epidural injection for lumbar stenosis
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Of 21 baseline patient characteristics — including the severity of spinal stenosis — evaluated in a secondary analysis, researchers did not find any consistent outcome predictors for epidural injections of lidocaine plus corticosteroid vs. lidocaine only for patients with lumbar spinal stenosis symptoms.
Researchers evaluated data from the Lumbar Epidural Steroid Injections for Spinal Stenosis (LESS) randomized controlled trial. Patients 50 years of age or older with moderate-to-severe leg pain and lumbar central spinal stenosis were included in the study. Patients were randomized to receive either epidural injections of corticosteroids with lidocaine (200 patients) or lidocaine only (200 patients).
At baseline, clinicians rated the severity of stenosis in the patient cohort and patients completed predictor and outcome measures. Researchers followed up with patients at 3 weeks and 6 weeks postoperatively, and they again completed outcome measures.
One baseline variable out of the 21 baseline patient characteristics and six outcomes showed a greater benefit from corticosteroid plus lidocaine vs. the use of lidocaine only at 3 weeks or 6 weeks, researchers noted.
Patients who rated their health-related quality of life as poor, compared with patients who rated it as high, had greater improvement with corticosteroid plus lidocaine than with lidocaine only for leg pain at 6 weeks, but not at 3 weeks. Researchers also found patients with lower health-related quality of life had better Roland-Morris Disability Questionnaire scores at 3 weeks postoperatively, but not 6 weeks.
Researchers concluded that none of the baseline patient characteristics could consistently predict outcomes for patients following epidural injections of lidocaine plus corticosteroid vs. lidocaine only. – by Robert Linnehan
Disclosure: Turner reported she received grants AHRQ R01HS019222-01 and AHRQ 1R01HS022972-01, and PCORI contract CE-12-11-4469. All were paid directly to the institution. Please see the full study for a list of all other authors’ relevant financial disclosures.
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