XIV ULUSLARARASI TÜRK OMURGA KONGRESİ, İzmir, Turkey, 25 - 27 May 2022, pp.450-451
Introduction: Caudal epidural injections and lumbar transforaminal injections of local anesthetic with steroid
provided effective and significant improvement to relieve pain originating from degenerative spine disorders
like as spinal stenoses and neural foraminal stenoses or disk herniations. With these injection methods, the drugs
are directly deliver into the target space to relieve pain. In general, the short-term results of these injections are
reported to be good and excellent, but there is ongoing debate about the mid-term and long-term results.
In this study, it was aimed to evaluate the short and long-term efficacy of combined epidural caudal and
transforaminal epidural injections in degenerative lumbar spine patients over 60 years of age with low back and
Methods: Between 2017 and 2019, 105 patients over the age of 60 who had spinal stenosis with radicular
symptoms and had at least 2 years of follow-up were included in the study. Visual analogue scala (VAS) and
Oswestry disability index (ODI) were measured pre-injection, 1, 3, 6, 12 and 24 months after the intervention.
Results: The VAS and ODI at each observation point of the post-operation were significantly decreased compared
with the pre-injection (P<0.05). Although an increase was observed in VAS and ODI scores in the long term (12th
and 24th months), it was observed that they remained significantly lower compared to the pre-injection period
(P<0.05). Sacral insufficiency fracture that was not detected in the first MRI image was observed in four of the
seven patients with increased post-injection pain in the 6th month control magnetic resonance imaging (MRI).
Conclusion: Fluoroscopically guided combined transforaminal and caudal epidural steroid injections offered a
safe, minimally invasive option for managing pain caused by degenerative spine disorders like as spinal stenosis
and neural foraminal stenosis.