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Predictive Factors for the Short-Term Efficacy of Epidural Injections in Lumbar Disc Herniation Treatment

  • Journal of Korean Society of Spine Surgery
  • Abbr : J Kor Spine Sur
  • 2020, 27(4), pp.138-146
  • Publisher : Korean Society Of Spine Surgery
  • Research Area : Medicine and Pharmacy > Orthopedic Surgery
  • Received : September 25, 2020
  • Accepted : December 17, 2020
  • Published : December 31, 2020

Jong Seok Baik 1 Yeong Tae Kim 2 DAE JIN NAM ORD ID 3 KIM TAE KYUN ORD ID 3

1원광대학교 의과대학 정형외과학교실
2원광대학교병원 정형외과학교실
3원광대학교병원

Accredited

ABSTRACT

Study Design: Retrospective study. Objectives: The purpose of this study was to analyze several factors affecting the efficacy of epidural steroid injections as a nonoperative treatment modality in lumbar disc herniation patients. Summary of Literature Review: Despite several studies, the normal course of intervertebral disc herniation is not fully understood, and the optimal timing of surgery is unclear. Methods: From January 2017 to April 2019, among outpatients in our hospital, 64 patients diagnosed with 3-4 or 4-5 single-level lumbar disc herniation and followed up for at least 6 weeks were included. Epidural steroid injection was performed in all patients during their 1-week admission. Symptoms improved in 36 patients (group 1) and persisted or recurred in 28 patients (group 2), who were finally treated surgically. Demographic factors, magnetic resonance imaging findings, and clinical assessments were analyzed. Results: The only demographic factor with a significant difference between groups was symptom duration. In magnetic resonance imaging, significant differences were found in disc sequestration and the degree of the herniated disc. At 6 weeks after the injection, significant differences were found between the 2 groups in visual analog scale scores and the Korean version of the Oswestry Disability Index. Conclusions: Several factors must be considered when treating patients with lumbar disc herniation. Of note, longer symptom duration was found to be associated with a lower effectiveness of conservative treatment. The effects of treatment could also be influenced by the disc form and the degree of disc herniation.

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