6/28/23, 10:58 PM LESS Pathway Feedback Search Clinical Topics Home Studies LESS LESS Disease Lumbar spinal stenosis Trial question What is the role of epidural corticosteroid injections in patients with lumbar spinal stenosis? Study design Multi-center Double blinded RCT Population Characteristics of study participants 55.0% female N = 400 45.0% male 400 patients (221 female, 179 male) Inclusion criteria: patients who had lumbar central spinal stenosis and moderate-to-severe leg pain and disability Key exclusion criteria: no stenosis of the central canal, spondylolisthesis requiring surgery, and a history of lumbar surgery or received epidural corticosteroid injections within the previous 6 months Interventions N=200 corticosteroid plus lidocaine (1 to 3 ml of 0.25% to 1% lidocaine followed by 1 to 3 ml of triamcinolone (60 to 120 mg), betamethasone (6 to 12 mg), dexamethasone (8 to 10 mg), or methylprednisolone (60 to 120 mg)) N=200 lidocaine (equivalent volume of 0.25% to 1% lidocaine alone) https://web.pathway.md/studies/recXpYJg83WrqsZcy 1/2 6/28/23, 10:58 PM LESS Pathway Primary outcome No significant difference in change in Roland-Morris Disability Questionnaire score at 6 weeks (-4.2 vs. -3.1; AD -1, 95% CI -2.1 to 0.1) Secondary outcomes No significant difference in intensity of leg pain (-2.8 vs. -2.6; AD -0.2, 95% CI -0.8 to 0.4) No significant difference in intensity of back pain at 6 weeks (4.3 vs. 4.4; AD -0.1, 95% CI -0.7 to 0.4) No significant difference in Brief Pain Inventory interference scale score at 6 weeks (3.5 vs. 3.8; AD -0.4, 95% CI -1 to 0.2) Safety outcomes No significant differences in 1 adverse event, serious adverse events. Significant difference in total adverse events (0.17 events vs. 0.29 events). Conclusion In patients who had lumbar central spinal stenosis and moderate-to-severe leg pain and disability, corticosteroid plus lidocaine was not superior to lidocaine with respect to change in Roland-Morris Disability Questionnaire score at 6 weeks. Reference Friedly JL, Comstock BA, Turner JA et al. A randomized trial of epidural glucocorticoid injections for spinal stenosis. N Engl J Med. 2014 Jul 3;371(1):11-21. Open reference URL https://web.pathway.md/studies/recXpYJg83WrqsZcy 2/2