Spinal Canal Opening Does Not Mean Better Success with Injections

Narrowing of the spinal canal is called spinal stenosis. This condition is common in older adults. It causes back and leg pain and difficulty walking. Treatment begins with nonsteroidal antiinflammatory drugs (NSAIDs), change in activity, and physical therapy.

Epidural steroid injection (ESI) is another nonsurgical treatment option. In this study, surgeons looked at the size of the spinal canal. They wanted to know if ESI would be successful more often if there was a larger opening around the spinal cord and spinal nerves.

Eighty-four (84) patients with lumbar spinal stenosis were included. CT scans were taken and measurements made of the spinal canal and nerve openings. They all got an ESI once a week for three weeks. They also received NSAIDs and physical therapy. Everyone was followed for at least two years.

The authors were surprised that canal dimensions did not predict patient response. Fifty (50) patients were no better and had to have surgery. Thirty-four (34) improved after ESI. Patients with large and small diameter canal openings were just as likely to be in one group as the other. The size of the spinal canal opening didn't seem to make a difference.

Based on the results of this study, CT scans of spinal canal dimensions are not useful in predicting results of treatment with ESI.