Disclosures: Cindy Tiu, DO: No financial relationships or conflicts of interest

Objective : Epidural steroid injections are widely practiced in the treatment of radicular pain such as sciatica. Repeat steroid injections are often performed for radicular pain in hopes of cumulative benefit or restoration of benefits that have diminished. A number of inherent factors thought to influence the development of sciatica have been studied, including gender, body habitus, and age. However, no studies have looked into how these factors influence the number of repeat epidural steroid injections needed to achieve noticeable pain relief. The purpose of this study is to determine if BMI, age, and gender influence the number of epidural steroid injections within two years of initial injection.

Design: Case series retrospective study

Setting : Academic spine center

Participants : 807 subjects who received cervical and/or lumbar epidural steroid injections from December 2016 to October 2019. 481 females and 326 males were included. BMI ranged from 15.9 to 60.8, averaging at 25.5. Ages ranged from 24 to 96 years, averaging at 49.5 years.

Interventions: Not applicable

Main Outcome Measures: Total number of injections from initial, body mass index, gender, age.

Results: Body mass index, gender, and age did not exhibit any statistically significant correlation with the number of injections within a 2 year period. Multiple simple linear regression models were studied to estimate the correlation among BMI, gender, and age in relation to number of total injections showing no statistical significance (P>0.05).

Conclusions: There does not appear to be sufficient evidence to demonstrate that BMI, age, or gender correlate significantly with the number of repeat epidural steroid injections. There currently is no consensus on what constitutes a “proper ESI”, including number, frequency, and timing of injections. The lack of correlation may suggest that number of repeat injections is largely a decision of individual physicians and their idiosyncratic judgments. Other factors contributing to increased frequency of injections need to be studied.

Level of Evidence: Level IV

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/repeat-epidural-steroid-injections-do-bmi-age-gender-play-a-role/