Effectiveness of single dose ultrasound guided caudal epidural steroid injection in improving Nerve Conduction Study parameters, functional status , symptoms in cases of chronic lumbosacral radiculopathy due to posterolateral disc herniation.
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 入组人数
- 60
- 试验地点
- 1
研究概览
简要总结
Chronic lumbosacral radiculopathy is a frequently encountered clinical condition characterized by pain radiating from the lower back into the lower extremities, often accompanied by sensory, motor, or reflex deficits along the affected nerve root distribution. One of the most common etiologies of lumbosacral radiculopathy is posterolateral intervertebral disc herniation, which exerts mechanical compression on the adjacent nerve roots and provokes a cascade of inflammatory responses in the surrounding neural tissue . This condition not only affects the physical functionality of patients but also significantly diminishes their quality of life, leading to psychological stress and economic burden due to reduced productivity and long-term healthcare needs.
Traditional fluoroscopy-guided techniques, though effective, involve radiation exposure and may be limited in resource-constrained settings. In contrast, ultrasound-guided (USG) caudal epidural steroid injections offer a radiation-free, real-time, and cost-effective alternative that allows direct visualization of the sacral hiatus, needle advancement, and drug dispersion. Despite increasing clinical use, there remains a relative paucity of high-quality evidence evaluating the effectiveness of USG-guided CESIs, particularly focusing on electrophysiological outcomes alongside clinical parameters.
Electrophysiological studies, including nerve conduction studies (NCS) and electromyography (EMG), offer objective tools to assess the functional integrity of the affected nerve roots. While pain and functional scales provide subjective evaluation, electrophysiological parameters serve as valuable biomarkers for nerve recovery and response to treatment. This observational study aims to investigate the effectiveness of a single-dose USG-guided caudal epidural steroid injection in patients with chronic lumbosacral radiculopathy secondary to posterolateral disc herniation. Specifically, the study evaluates the intervention’s impact on electrophysiological parameters, functional status, radicular symptoms, and pain intensity over a defined follow-up period. By integrating both objective and subjective outcome measures, this research seeks to contribute meaningful data to support the broader application of USG-guided CESIs as a safe, effective, and non-surgical treatment option for managing chronic lumbosacral radiculopathy.
研究设计
- 研究类型
- Observational
入排标准
- 年龄范围
- 30.00 Year(s) 至 70.00 Year(s)（—）
- 性别
- All
入选标准
- •Previous Spine Surgery: History of lumbar spine surgery at L4-L5, L5-S
- •Systemic or Local Infection: Presence of localized skin infection at the injection site or systemic infection.
- •Coagulopathy or Anticoagulant Therapy: Patients with bleeding disorders or those on anticoagulant medication without proper management.
- •Severe Neurological Deficits: Progressive motor weakness, cauda equina syndrome, or loss of bowel/bladder control.
- •Allergy to Medications: Known allergy to local anesthetics, steroids.
- •Non-Radicular Pain: Patients with purely mechanical low back pain without radiating leg symptoms.
- •Severe Comorbidities: Uncontrolled diabetes, severe cardiovascular disease, or malignancy.
- •Pregnancy or Lactation: Pregnant or breastfeeding women are usually excluded to avoid potential harm.
- •Psychiatric Disorders: Severe psychiatric illnesses that may impair pain reporting or study compliance.
- •Substance Abuse:Current or recent history of substance abuse (alcohol, opioids, or recreational drugs).
- •Sacrococcygeal tumor or fractures.
- •Patient on chronic steroids, DMARD’s & opioids.
排除标准
- •Previous Spine Surgery: History of lumbar spine surgery at L4-L5, L5-S
- •Systemic or Local Infection: Presence of localized skin infection at the injection site or systemic infection.
- •Coagulopathy or Anticoagulant Therapy: Patients with bleeding disorders or those on anticoagulant medication without proper management.
- •Severe Neurological Deficits: Progressive motor weakness, cauda equina syndrome, or loss of bowel/bladder control.
- •Allergy to Medications: Known allergy to local anesthetics, steroids.
- •Non-Radicular Pain: Patients with purely mechanical low back pain without radiating leg symptoms.
- •Severe Comorbidities: Uncontrolled diabetes, severe cardiovascular disease, or malignancy.
- •Pregnancy or Lactation: Pregnant or breastfeeding women are usually excluded to avoid potential harm.
- •Psychiatric Disorders: Severe psychiatric illnesses that may impair pain reporting or study compliance.
- •Substance Abuse:Current or recent history of substance abuse (alcohol, opioids, or recreational drugs).
- •Sacrococcygeal tumor or fractures.
- •Patient on chronic steroids, DMARD’s & opioids.
研究者
Lt Col Dr Mohit Kataruka
AIIMS Kalyani