요천추 신경증에 의한 하지방사통의 미추경막외 주사 치료

Abstract

An spinal epidural injection is a relatively benign procedure and widely used for symptomatic relief of back and radicular leg pain.The authors evaluated the efficacy of caudal epidural injection with corticosteroids and local anesthetics which was performed by a neurosurgeon for the treatment of ongoing lumbosacral radicular symptoms. Between July 1997 and June 1998, 20 patients with back pain and radiating leg pain invloving lumbosacral degenerative spine disease, who refused operation or were unsuitable for general anesthesia, were treated and followed for more than 6 months. All procedure was done under radiogaphical guidance aseptically. The authors used the mixed solution of 1% lidocaine(6 cases) or 0.25% bupivacaine(14 cases) with methylprednisolone acetate(1-2ml). The mean total volume of the mixture was 15.6 ml. The preoperative neurosurgical diagnosis included 11 lumbar disc herniation,6 lumbar stenosis and 3 spondylolisthesis and the invloved nerve roots presenting with typical radiculopathy were L5 root(17 patients), S1 root(15 patients), L4 root(4 patients), and S2 root(1 patient). The responses from patients were classified into 4 groups, and excellent or good results with marked reduction on radicular leg pain were noted in 19 cases. There were a few transient complications such as headahce, leg numbness,perisacral hypesthesia, injection pain, constipation and malpositioned spinal needle. The authors suggest that the cadual epidural injections is a reasonable alternative to spinal surgery if patient's pain is severe enough and you are exhausted other methods to relieve the pain.