Short Term Results After Local Application of Steroids and Anesthetics in Patients with Painful Spine Conditions

ABSTRACT Introduction: Spinal pain is the most common of all chronic pain disorders. Imaging studies can be used to determine whether a pathological process is associated with the patient’s symptoms. Objective: To determine the short-term efficiency of local instillation of steroids in patients with painful spine conditions. Materials and methods: A prospective study included 35 patients with diagnosis of lumbar or cervical radiculopathy, or cervical and lumbar syndrome at the Department for the Physical Medicine and Rehabilitation, Department for the Orthopedics and Traumatology, and Department for the Neurosurgery, Clinical Canter University of Sarajevo (KCUS). A clinical examination, visual pain scale (VAS) and Oswestry Disability Index (ODI) were performed prior to the needle procedure and seven days after it. Descriptive and comparative statistics were used for comparison of pre and post-interventional results. This procedure was done for the first time in our region. Results: The males and females were equally represented in this study (17:18). The patients were 29 to 80 years old. The highest number of patients have been between 40-60 years, older then that have been 44,2% of patients, and younger only 8,5%. Patients have complained about the radicular pain along the legs or arms or back or neck pain. Most of them had disc herniation–57,14%, 8,57% had bulging disc, 8,57% had spinal canal stenosis, 5,71% had fasetarthrosis, rest of them had combination of those conditions. There was a statistically significant difference between the value of ODI score before procedure and 7 days later (26±10:16±12; p<0,001). The difference was also statistically significant in VAS values (7±1:1±1; p <0,001). Discussion: Our study suggests that needle instillation of steroid and lidocaine is effective in short-term pain occurs in different painful spine conditions (Sy cervicale, lumbare and radiculopathy). It is valuable alternative to the classic methods of physical and drug therapy. It can also postpone surgical treatment, and it is very useful in situations of diffuse degenerative changes when is very important to define exact source of pain, like for instance in hip-spine syndrome.