The role of epidural cortisone injection in the treatment of diskogenic low back pain.

Primary treatment by epidural injection of cortisone in patients suffering from characteristic diskogenic disease was helpful in 82% of patients. However, when given after three months of back pain, after previous laminectomies, and in patients actually suffering from an unstable spine which required fusion, epidural injections were of little value. No complications resulted from the injection and there was no compelling evidence to indicate that the placement of the needle by radiologic means is necessary. Because of these benefits and the fact that all of the patients were candidates for laminectomy, the use of this injection prior to surgery should be considered. The number of injections that may reasonably be given, the degree to which the patient should become asymptomatic, and the period of time during which relief continues remain to be clarified by a larger and more sustained study.