Steroid Injections May Worsen Spinal Stenosis Outcomes
(HealthDay News) – The use of epidural steroid injections (ESIs) may be linked to worse outcomes over four years in patients with lumbar spinal stenosis whether they are treated surgically or nonsurgically, according to a study published in the Feb. 15 issue of Spine.
Kris Radcliff, MD, from the Thomas Jefferson University in Philadelphia, and colleagues compared 69 patients with lumbar spinal stenosis who received ESI within the first three months of enrollment in SPORT (the Spine Patient Outcomes Research Trial) to 207 patients who did not receive epidural injections during the first three months of the trial.
The researchers observed a significant increase in baseline preference for nonsurgical treatment among ESI patients compared to non-ESI patients (62 vs. 33%). Among ESI patients who ultimately underwent surgical treatment, there was an average 26-minute increase in operative time and a 0.9 day increased length of stay. Over four years, there was significantly less improvement in 36-Item Short Form Health Survey (SF-36) Physical Function among surgically treated ESI patients versus non-ESI patients (14.8 vs. 22.5). Among the nonsurgically treated patients, there was significantly less improvement in SF-36 Body Pain in ESI patients compared to non-ESI patients (7.3 vs. 16.7); the same was true for the SF-36 Physical Function (5.5 vs. 15.2).
"Despite equivalent baseline status, ESIs were associated with significantly less improvement at four years among all patients with spinal stenosis in SPORT," the authors write.