ESRA Academy. Lopez N. Sep 8, 2016; 138408; 0252 Topic: INTERVENTIONAL TECHNIQUES
Nerea Lopez
Nerea Lopez

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Background and Aims:

Lumbar spinal stenosis (LSS) is a degenerative disease with a decrease in the area of the spinal canal and cause back and leg pain due to the compression of neuronal structures and intraspinal vasculature due to the narrowing of the spinal canal. LSS is quite common in people older than 65 years, and its most significant clinical symptom is intermittent neurogenic claudication.

Incially, the treatment is conservative, failing this, surgical or non-surgical modalities such as epidural injections (EI), especially at the level of affected roots and fluoroscopy are contemplated. 
We objetive is to assess the effectiveness of lumbar epidural 'blinded' injections with local anesthetic (LA) and steroids in providing effective pain relief with improvement in functional status for the management of chronic low back and lower extremity pain related to lumbar spinal stenosis in elderly.  


Retrospective observational study is performed involving 116 patients mostly over 70 years with LSS in 5-year follow up. All patients received lumbar EI with LA (ropivacaina 0.2 %) and betamethasone 12 mg without fluroscopy. Outcomes were assessed utilizing the VAS at 1,3, 6, 12 post-treatment.  


Significant relief was seen in 63% of patients. The time of this improvement has been less than 2 months.


The EI in LSS is a minimally invasive and cost effective technique compared to surgery, offering an improvement of symptoms in more than 60% with short-term duration. The fluoroscopy guidance is mandatory to improve results. The surgery could be the first step in the treatment in selected patients. 

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