To study the effectiveness of lumbar epidural dexamethasone with bupivacaine versus triamcinolone with bupivacaine in patients with prolapsed intervertebral disc

A prolapsed intervertebral disc in the spine is a condition during which a nucleus pulposus is displaced from intervertebral space. It is a common cause of back pain.

Several nonsurgical medical treatments have been proposed for lumbosacral radicular pain, from lifestyle changes, exercise and physical therapy to analgesic local/oral drugs and epidural steroid injections (ESIs).

An ESI is a common and minimally invasive procedure, performed to successfully treat lumbosacral radicular pain, which has also proved its effectiveness in the treatment of acute back pain and leg symptoms. The injections are used to deliver steroids, and sometimes local anaesthetics, to the epidural space, directly to the site that causes the pain using a caudal, interlaminar route. The preparation of steroids used in the epidural space can be divided into 2 groups particulate such as methylprednisolone, betamethasone, and triamcinolone; and non- particulate like dexamethasone phosphate. Corticosteroids decrease inflammation through inhibition of prostaglandins in the arachidonic acid cascade, which may improve microcirculation through decreasing capillary permeability, nerve root oedema, and ischemia.Steroids also directly inhibit the excitation of pain-generating c-fibre neurons.Various steroid preparations are utilized for Epidural Steroid Injections (ESIs), including dexamethasone, triamcinolone, betamethasone, and methylprednisolone along with local anesthetics. The Aim of our study is to systematically evaluate and compare the therapeutic effectiveness of lumbar epidural injections containing dexamethasone versus triamcinolone in managing pain and enhancing functional outcomes in patients diagnosed with prolapsed intervertebral disc, contributing valuable insights to optimize treatment approaches for this common spinal condition.