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- Title
Evaluation of Sagittal Spinopelvic Alignment on Analgesic Efficacy of Lumbar Epidural Steroid Injection in Geriatric Patients.
- Authors
Kim, Hee Jung; Ban, Min Gi; Rho, Miribi; Jeon, Woohyuk; Kim, Shin Hyung
- Abstract
Background and Objectives: The aim of this study was to evaluate the impact of sagittal imbalance based on pelvic incidence–lumbar lordosis (PI-LL) mismatch on the analgesic efficacy of epidural steroid injection in geriatric patients. Materials and Methods: Patients aged 65 years or older who received lumbar epidural steroid injections under fluoroscopy were enrolled. The cutoff of PI-LL mismatch >20° was used as an indicator of a marked sagittal imbalance. The cross-sectional area of the psoas and paraspinal muscles, as well as the paraspinal fat infiltration grade were measured. A 50% or more decrease in pain score at four weeks after injection was considered as good analgesia. Variables were compared between PI-LL ≤ 20° and >20° groups and multivariate analysis was used to identify factors related to pain relief after injection. Results: A total of 237 patients consisting of 150 and 87 patients in the PI-LL ≤ 20° and >20° groups, respectively, were finally analyzed. Female patients, patients with lumbar surgery history, and the smaller cross-sectional area of the psoas muscles were predominantly observed in patients with sagittal imbalance. There was no difference in analgesic outcome after injection according to the PI-LL mismatch (good analgesia 60.0 vs. 60.9%, p = 0.889). Multivariate analysis showed that pre-injection opioid use, moderate to severe foraminal stenosis, and high-graded paraspinal fat infiltration were significantly associated with poor analgesia after injection. Conclusions: There was no significant correlation between sagittal spinopelvic alignment and pain relief after lumbar epidural steroid injection for geriatric patients.
- Subjects
EPIDURAL injections; ANALGESIA; PSOAS muscles; WOMEN patients; MULTIVARIATE analysis; FLUOROSCOPY; LORDOSIS
- Publication
Medicina (1010660X), 2022, Vol 58, Issue 10, p1383
- ISSN
1010-660X
- Publication type
Article
- DOI
10.3390/medicina58101383