Efficacy of ultrasound-guided epidural block in axial spondyloarthritis patients

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Created On: 19/02/2021

Efficacy of ultrasound-guided epidural block in axial spondyloarthritis patients

A randomized controlled trial was carried to assess the efficacy of epidural injection on spine mobility, pain, disease activity, and the activity of everyday living in individuals having spondyloarthritis with limited spine mobility.

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Key take away

The caudal epidural injection of triamcinolone and lidocaine is a practical and cost-effective approach for alleviating pain and improves the functioning of the spine and disease activity scores in individuals suffering from axial spondyloarthritis.

Background

Method

The study cohort included 47 axial spondyloarthritis patients. Individuals were allocated into two arms: (I) Group A was administered caudal epidural injections, ultrasound-guided, with 1% lidocaine hydrochloride mixed with triamcinolone (ii) Group B was not given any injections. All the subjects fulfilled the Assessment of Spondyloarthritis International Society (ASAS) criteria for axial spondyloarthritis.

The outcome parameters were: (i) visual analogue scale, (ii) lateral lumbar flexion, (iii) modified Schober test, (iv) Oswestry disability index (ODI), and (v) Ankylosing Spondylitis Disease Activity Score (ASDAS) with an evaluation at baseline, two and eight weeks after therapy.

Result

A substantial difference was noted between both the groups regarding spine mobility, pain, ODI, and ASDAS scores in favor of group A. This impact was at its maximum after two weeks. Despite the decrease in this effect after two months, the difference between the arms remained substantial. Young age, elevated disease activity, and a shorter duration of disease were linked with improved outcomes.

Conclusion

The epidural injection of triamcinolone and lidocaine is beneficial to treat axial spondyloarthritis patients with relatively sustained effects and acceptable complications.