Article
Conservative treatment of lumbar spinal stenosis with epidural catheter therapy
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Published: | June 13, 2005 |
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Outline
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Introduction
One of the clinically most important degenerative spinal disorders in the aging population is lumbar spinal canal stenosis. Sufficient conservative treatment of spinal canal stenosis is necessary due to high overall risk of surgical intervention in elderly patients frequently presenting with co-morbidity. Up to date, conservative management consists of physiotherapy, oral medication such as non-steroidal-anti-inflammatories, prostaglandines, interleukines or calcitonin and intermittend epidural steroid injections. It is now consensus that enzymatic and neurochemical mediation is responsible for pain and inflammation in spinal canal stenosis.
Recent studies suggest that permanent epidural steroid injections benefit lumbar stenosis. We analysed the short- and midterm outcome of conservative treatment of SCS with epidural anti-inflammatories administered via permanent epidural catheter.
Patients, Material and Method
40 Patients aged 60 to 88 years with diagnosed SCS following well established clinical and radiological criteria were included in this study. Daily treatment included the administration of a local anastaetic, an opioid and a steroid-injection for a duration of 4 to 10 days. Additionally, all patients underwent physiotherapy. The outcome after 6 to 12 month was evaluated using the Oswestry-Disability-Questionair (ODQ), visual analogue scale and walking distance before and after treatment.
Results
Detailed data on clinical and radiological results of 40 patients followed up at least for 6 months will be presented.