Caudal epidural shots may be effective for herniated discs of lumbar spine

Oct 21 2011
Patients who have endured a herniated disc in their lumbar spine, as well as radiculitis that affects the legs, may benefit from caudal epidural shots.

Previous research on the treatment for these individuals has been varied. The latest study, published November 1 in Spine, suggests that this medical approach may be effective for this condition.

The spinal cord connecting the brain to the rest of the body is protected by the vertebrae, the facet joints and the intervertebral discs that cushion the spaces in between the bones. Each disc has two layers: the outer annulus fibrosus, and the inner, gel-filled nucleus pulposus. The spinal cord runs the length of the back through the discs and vertebrae, which form a protective tunnel.

Intervertebral discs may become damaged by injury, disease or age-related wear and tear. If one of these discs ruptures or bulges out, a condition known as a herniated disc, it may put pressure on the surrounding nerves. Such damage can cause local back pain that may radiate to the legs, a phenomenon known as radiculitis.

There are several medications that may be taken as a conservative approach to a herniated disc.These include acetaminophen, non-steroid anti-inflammatories such as ibuprofen and oral steroids. Narcotics may also be prescribed, but they carry risks of addiction and losing their effectiveness over time.

One other treatment is caudal epidural injections. In this procedure, a physician uses x-rays and special dyes to guide a shot delivered to the epidural space that houses the nerve roots. These injections may include a mix of local anesthetic and steroid medication to reduce inflammation.

However, previous research has been inconsistent in describing the effectiveness of these procedures when it comes to treating herniated discs in the lumbar spine and radiculitis. A team of scientists decided to assess this approach in a randomized, controlled trial.

The researchers enrolled 120 patients into their study, who were divided into two groups: one received caudal epidural injections of a local anesthetic, while the other had the same procedure, but received a mix of anesthetic and steroid medication.

Results showed that both groups experienced relief in their symptoms, but those who received the steroid as well as the anesthetic required fewer injections to reap the same benefit.