Introduction: Trans-foraminal epidural steroid injections (TFESI) have been extensively used for treatment of pain due to lumbosacral disc disease. There has been an ongoing debate regarding benefits and safety of non-particulate steroids over particulate steroids. We have studied outcomes following injection of methylprednisolone versus dexamethasone in symptomatic lumbosacral disc disease.

Materials and Methods: A total of 100 patients (50 in each group) were chosen and randomized to be included in either arm of the study. Patients were assessed at different time points following a one-timetrans-foraminal epidural steroid injection. Outcome was assessed using the Numerical Rating Scale (NRS).

Results: Overall, the extent, as well as duration of pain relief was significantly better in the methylprednisolone group, than in the dexamethasone group. Except for transient paraesthesias, there were no serious adverse effects in either group.

Conclusion: There is satisfactory pain relief with both the medications when used for TFESI, but the efficacy of epidural methylprednisolone is greater than dexamethasone, and the effects tend to last longer. There is no difference in adverse effects between both the drugs when used for lower lumbar epidural injections.

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Dr Muhammad Bin Abdul Hamid

Junior Resident, Deptt of Orthopaedics, Government Medical College, Srinagar, India