Comparison of the Particulate Steroids, Betamethasone and Methylprednisolone, in Caudal Steroid Injection Under Ultrasound Guidance.

Abstract

BACKGROUND:

Pain relief in lumbar disc hernias is a challenging condition. This study retrospectively compared particulate steroids, methylprednisolone acetate (mid-term effective), against betamethasone acetate (long-term effective) on ultrasound-guided caudal epidural injection for lumbar disc herniation.

METHODS:

A total of 40 patients with L4-5 and/or L5-S1 disc herniation were treated with ultrasound-guided caudal epidural injection between September 2021 and June 2022. Nineteen patients who were given methylprednisolone acetate (group A) as a steroid and a total of 21 patients who were used betamethasone acetate (Group B) were retrospectively collected, and their pain levels and functional improvement were compared retrospectively before, immediately after, and 3 weeks after the injection in terms of the visual analog scale (VAS) and Oswestry Disability Index (ODI) as the efficacy value.

RESULTS:

There was no statistically significant difference between the groups regarding age, gender, and body mass index (P > 0.05). In group A, preop VAS was 8.84 ± 0.76, immediate postop period 3.10 ± 1.37, and postop third week was 4.73 ± 2.32. In group B, the preop VAS was 8.76 ± 0.76, the postop early period was 3.14 ± 1.27, and the postop third week was 3.12 ± 1.30. In group A preop ODI was 49.84 ± 9.11 and postop third week was 22.84 ± 6.44. In group B, the preop ODI was 46.71 ± 16.15 and postop third week was 30.80 ± 17.65. Significant changes were observed in the reduction of VAS values after the procedure in both groups during the early postoperative period and the third week (P value < 0.05). However, a significant difference was not found between the changes in VAS values between the groups (P value > 0.005). Similarly, significant changes were observed in the decrease of ODI values after the procedure in both groups during the early postoperative period and the third week (P value < 0.05). However, no significant difference was observed in the ODI scores between the two groups.

CONCLUSIONS:

No significant difference was observed between betamethasone and methylprednisolone. Both steroid groups showed a substantial improvement in the preoperative pain scores of the patients.

• Authors: Ali Guler, Yigit Can Senol, Afsin Emre Akpinar, Goksal Gunerhan, Ali Dalgic
• Journal: World neurosurgery (World Neurosurg) Vol. 178 Pg. e421-e426 (Oct 2023) ISSN: 1878-8769 [Electronic] United States
• PMID: 37495099 (Publication Type: Journal Article)
• Copyright: Copyright © 2023 Elsevier Inc. All rights reserved.

Chemical References

• Methylprednisolone
• Methylprednisolone Acetate
• Betamethasone
• Steroids

Topics

• Humans
• Methylprednisolone (therapeutic use)
• Intervertebral Disc Displacement (diagnostic imaging, drug therapy, surgery)
• Methylprednisolone Acetate (therapeutic use)
• Retrospective Studies
• Injections, Epidural (methods)
• Betamethasone (therapeutic use)
• Steroids (therapeutic use)
• Pain
• Lumbar Vertebrae (diagnostic imaging, surgery)
• Treatment Outcome