Background. Lumbar spinal stenosis (LSS) causes low back pain, leg pain, numbness in the leg, and neurogenic intermittent claudication. Epidural steroid injection (ESI) has been used for treating spinal stenosis symptoms. We hypothesized that dural pulsation was variable for lumbar spinal stenosis. In cases of the presence of dural pulsation, the pain relief after the ESI was better than in the absence of dural pulsation. This study aimed at investigating the relationships between the presence or absence of spinal dural pulsations and the efficacy of ESI. Methods. A total of 71 patients were enrolled in this prospective study. Prior to the ESI, the dural pulsation was measured using a 5-1 MHz array ultrasound transducer. The visual analogue scale (VAS) score was measured pre-ESI and 2 weeks post-ESI and 4 weeks post-ESI. At 4 weeks post-ESI, dural pulsation was rechecked. Results. The VAS scores improved after the ESI procedure regardless of the presence or absence of dural pulsation. There was a correlation between the pulsation of the dura and post-ESI VAS scores. However, VAS was not significantly different for different grades of stenosis. Conclusion. The ESI was effective in patients with spinal stenosis in short-term follow-up. Dural pulsation of the spinal cord was a positive predictive factor for the ESI effect, but the grade of spinal stenosis severity had no effect on the effectiveness of ESI.

中文翻译：

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腰椎硬膜外类固醇注射短期疗效与硬脊膜搏动的关系

背景。腰椎管狭窄症 (LSS) 会导致腰痛、腿痛、腿部麻木和神经源性间歇性跛行。硬膜外类固醇注射（ESI）已用于治疗椎管狭窄症状。我们假设硬脑膜搏动对于腰椎管狭窄是可变的。在存在硬脑膜搏动的情况下，ESI 后的疼痛缓解效果优于不存在硬脑膜搏动的情况。本研究旨在探讨硬脊膜搏动的存在与否与 ESI 疗效之间的关系。方法。共有 71 名患者参加了这项前瞻性研究。在 ESI 之前，使用 5-1 MHz 阵列超声换能器测量硬脑膜搏动。在 ESI 前、ESI 后 2 周和 ESI 后 4 周测量视觉模拟评分 (VAS)。ESI 后 4 周，重新检查硬脑膜搏动。结果。无论是否存在硬脑膜搏动，VAS 评分在 ESI 手术后均有所改善。硬脑膜搏动与 ESI 后 VAS 评分之间存在相关性。然而，对于不同程度的狭窄，VAS 没有显着差异。结论。ESI在短期随访中对椎管狭窄患者有效。脊髓硬脑膜搏动是ESI效果的阳性预测因素，但椎管狭窄严重程度对ESI效果没有影响。