Subarachnoid corticosteroid injection following inadequate response to epidural steroids for sciatica

Area of Science:

• Pain Medicine
• Neurology
• Pharmacology

Background:

• Epidural steroid injections are a common treatment for various pain conditions.
• Limited efficacy of epidural steroids necessitates exploring alternative or adjunctive therapies.

Purpose of the Study:

• To evaluate the effectiveness of subarachnoid steroid injections in patients unresponsive or partially responsive to epidural steroid injections.
• To determine if subarachnoid steroid administration provides additional pain relief.

Main Methods:

• Retrospective review of pain clinic patient records.
• Analysis of patient outcomes following subarachnoid steroid injections after prior epidural steroid treatments.

Main Results:

• Only one out of thirteen patients (7.7%) with no relief from epidural steroids showed improvement after subarachnoid injection.
• Five out of six patients (83.3%) with partial relief from epidural steroids experienced further improvement post-subarachnoid injection.

Conclusions:

• Subarachnoid steroid injections are unlikely to benefit patients who derive no pain relief from epidural steroid injections.
• Subarachnoid steroid injections may offer significant benefit for patients experiencing partial relief from epidural steroid injections.