Epidural versus facet joint local steroid infiltration for lumbar radiculopathy

Abstract EN

Patients & Methods: Forty patients complaining of low back pain with lumbar radiculopathy were randomized to receive methyl prednisolone acetate (MPA) injections either epidurally (Group I) or intra-articularly in lumbar facet joints (Group II).

Patients were examined before injection, one week later and then after one month at follow-up.

Results: A significant improvement was observed in both groups, but this was independent of the procedure of treatment given.

In group I (15 patients); 12 patients (80%) had initial pain relief after 1 week from epidural injection and 5 patients (33%) of them still showed improvement at one month follow up.

As for group II (18 patients), 10 patients (56%) showed initial improvement after 1 week from facet joint injection while after one-month follow-up, 4 patients (22%) of them showed persistent improvement.

There was an insignificant difference in patients’ plasma levels of adrenocorticotrophic hormone and cortisol between results at baseline and after one week follow up in both groups, albeit it’s decreased level.

Conclusion: Thus, epidural injection therapy is a useful short-term means of relieving pain but probably has less effect on the long-term history of symptoms.

Also, facet joint injection is a well-tolerated, easy technique with few complications and a lesser dose of MPA.