Comparative effects of epidural steroid injections on disc bulging and disc protrusion in patients with discogenic low back pain

Abstract Objective In this study, we aimed to examine the effect of epidural steroid administration (ESI) on disc bulging and disc protrusion in patients with discogenic low back pain. Materials and Methods The prospective randomized study reviewed medical records of 71 patients with discogenic low back pain who were radiologically proven as disc bulging and disc protrusion with or without radicular pain and did not require surgery at Neurosurgery Department between June 2021 and June 2022. All the patients underwent ESI and attended regular follow-up visits for a period of 6 months. Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) scores were assessed before the procedure, one week after the procedure, one month after the procedure, and six months after the procedure. Results There was no significant difference between patients with disc bulging and disc protrusion in terms of demographic characteristics. In both groups, both VAS and ODI scores showed a significant decrease in the post-procedure period compared to the pre-procedure period. However, there was no significant difference between the two groups with regard to the reduction rate between post-procedure 1st week VAS scores and pre-procedure VAS scores. Conclusion The results indicated that lumbar interlaminar steroid injection is an effective treatment for disc bulging and discogenic pain due to protrusion and that both groups benefited from ESI administration. Additionally, except for the first week of injection, relief due to the use of epidural steroids was observed to be greater in the Disc Protrusion group compared to the Disc Bulging group.