Abstract Background: Caudal epidural steroid injection (CESI) is a well-established minimally invasive technique used in the management of radicular pain secondary to prolapsed intervertebral disc (PIVD). Limited evidence exists comparing the efficacy of CESI at specific lumbar levels, particularly between L5 and S1 radicular pain. Objective: The objective of the study was to evaluate and compare the clinical efficacy of CESI in patients with L5 versus S1 radicular pain due to PIVD. Materials and Methods: A prospective interventional study was conducted over a period of 18 months in the department of physical medicine and rehabilitation at a tertiary care institute. Forty patients with MRI-confirmed PIVD at either L4–5 or L5–S1 level were assigned to two groups based on the involved nerve root (L5 or S1). Each participant received a single CESI containing methylprednisolone acetate, 2% lignocaine, 0.25% bupivacaine and normal saline under aseptic precautions. Outcomes were assessed using the Visual Analogue Scale (VAS) for pain and the Oswestry Disability Index (ODI) for functional status at baseline, 1 month and 3 months post-injection. Results: Both groups showed statistically significant improvement in VAS and ODI scores at 1-month and 3-month follow-ups compared to baseline ( P 0.05). Conclusion: CESI is effective in reducing pain and improving function in patients with radicular pain due to PIVD. Its efficacy appears comparable in both L5 and S1 radicular pain, supporting its continued use regardless of the affected nerve root level.
Biswas et al. (Thu,) studied this question.