Evaluation of restless leg syndrome symptoms in patients with lumbosacral canal stenosis comparison with normal population

Comparative effectiveness of paravertebral Ozone injection and caudal epidural steroid-hyaluronidase injection in lumbosacral spinal stenosis

BACKGROUND

Lumbosacral spinal stenosis (LSS) is the narrowing of the lumbar spinal canal. LSS usually happens in older people who do not have the proper physical condition to undergo surgery. Therefore, minimally invasive methods such as Ozone therapy and epidural injection can be used in these patients.

OBJECTIVE

The objective this study was to compare the effect of caudal epidural steroid-hyaluronidase injection with paravertebral intramuscular Ozone injection on reducing pain in patients with LSS.

METHODS

A total of 30 patients suffering from LSS randomized to two groups. Group A (n = 15) received three paravertebral intramuscular infiltrations of the Ozone, Group B (n = 15) received a caudal epidural injection of steroid-hyaluronidase. The effects of the interventions were evaluated by measuring Visual analog scale (VAS), Oswestry Disability index (ODI), Quebec Back Pain Disability (QBPDS) and Roland Morris low back pain questionnaire (RMQ) before the interventions and at 2 weeks, 4 weeks, and 8 weeks after the interventions.

RESULTS

Within-group changes showed significant improvement in VAS, ODI, RMQ, and QBPDS scores in both groups from pre-treatment to end of follow-up (all p < 0.05). The mean VAS score at all follow-up had significant differences between the two groups (p < 0.01). The mean ODI, RMQ, and QBPDS scores at 2-week and 4-week had significant differences between the two groups (p < 0.01). At the 8-week follow-up, there was no significant difference between groups concerning mean ODI, RMQ, and QBPDS scores (p > 0.05).

CONCLUSION

Both intramuscular injection Ozone and caudal epidural injection steroid- hyalaz significantly reduce pain. The existing data suggested 8 weeks improvements in pain severity are more significant for paravertebral Ozone injection, compared to caudal epidural steroid-hyaluronidase injection.

A comparison between effectiveness of gluteal trigger point and epidural steroid injection in lumbosacral canal stenosis patients: a randomized clinical trial

BACKGROUND

Lumbosacral Spinal Stenosis (LSS) is a degenerative spine disease and a major cause of pain and disability, especially in geriatrics. Primary symptom control in patients with LSS includes conservative treatment and non-surgical methods. In this study, we aimed to compare the effect of steroid injection via epidural and gluteal trigger point techniques.

METHODS

Patients aged 40-75 years old who had pain and other clinical signs of spinal stenosis in the last 6 months were included in our study and divided into two groups of gluteal trigger point (TP) or epidural steroid injection (ESI). The patients were evaluated based on the visual analog scale (VAS), Roland-Morris Disability Questionnaire (RDQ), Oswestry Disability Index (ODI), and the Quebec back pain disability scales during their pre-injection period and 2 weeks after follow-ups till 8 weeks. A P value of less than 0.05 was considered significant.

RESULTS

A total of 44 patients were included in our study. The TP group had a significant decrease in comparison with their follow-ups; however, in the epidural group, the significant decrease was only observed compared to the pre-injection period and the scores did not have any significant decreases after the second week regarding the ODI, RQM, and VAS scales. The TP group demonstrated significantly higher scores of decreases of ODI and Quebec score compared to the epidural group at weeks 4 and 8. Regarding RQM, the TP groups demonstrated significantly higher scores of decreases compared to the epidural group at weeks 2, 4 and 8. (p < 0.001 p = 0.008, and p < 0.001, respectively).

CONCLUSION

Both epidural and TP steroid injection significantly reduced the patients' pain and improved their QoL and function; however, more satisfactory results were observed in the TP group during the patients' follow-ups, while the epidural group demonstrated only statistically significant improvement during the short-term follow-up.