Сaudal epidural blocks in the treatment of pain syndromes of the lumbosacral spine in degenerative-dystrophic diseases

Abstract

Background. Сaudal epidural blocks — minimally invasive method of treating pain syndromes of the low back through the introduction of drugs into the epidural space through hiatus sacralis. The purpose of the study was to analyze the results of the treatment for pain syndromes of lumbosacral spine in its degenerative-dystrophic diseases by сaudal epidural blocks. Materials and methods. Retrospective analysis was performed in 49 patients (23 men and 26 women) aged 55.4 ± 2.1 years with complaints of low back pain, who were treated by сaudal epidural blocks. Group 1 — 27 persons with protrusions or herniated discs. Group 2 — 22 patients with lumbar spinal stenosis. The period of observation was at least 3 months after the procedure. Evaluation of treatment results was carried out by Visual analogue scale for pain assessment, Roland-Morris indices of the quality of life and Oswestry Disability Index (ODI). The number of the procedures performed was 1–3. Results. In group 1, it was marked a persistent regression of pain syndrome from 7.07 ± 1.10 cm to 3.29 ± 1.29 cm after treatment, 4.02 ± 1.64 cm — in 1 month, 4.07 ± 1.81 cm — in 3 months (p < 0.05). In group 2, we observed less pronounced and lasting regression of pain syndrome, from 7.18 ± 1.29 cm to 3.50 ± 1.33 cm after the procedure, 3.86 ± 1.72 cm — in 1 month, 4.18 ± 2.03 cm — in 3 months (p < 0.05). Regression of pain syndrome is also strongly correlated with Roland-Morris indices of the quality of life and ODI. Conclusions. Сaudal epidural block is an effective treatment of low back pain with hernias and protrusions of intervertebral discs, as well as lumbar spinal stenosis. Regression of pain correlated with improvement of quality of life according to the Roland-Morris disability questionnaires and ODI at all stages of monitoring.

Keywords

• pain
• lumbosacral spine
• сaudal epidural blocks