Epidural Bupivacaine with or Without Corticosteroid for Lumbar Disc Prolapse: A Randomized Controlled Trial

Background: Epidural interlaminar injections are widely used in the management of intervertebral disc prolapse; however, the additional benefit of corticosteroids over local anesthetics alone remains controversial. Objectives: To assess and compare the therapeutic efficacy of epidural interlaminar corticosteroid with bupivacaine versus epidural interlaminar bupivacaine alone in patients with intervertebral disc prolapse. Methods: In this randomized controlled study, 180 patients were allocated into two groups receiving either epidural interlaminar steroid with bupivacaine or bupivacaine alone. Pain intensity, functional disability, neurological recovery, and analgesic requirement were assessed over a 12-week follow-up period. Results: Both groups demonstrated significant improvement; however, the steroid-bupivacaine group showed significantly lower VAS and ODI scores, higher JOA scores, and reduced need for repeated analgesics at 12 weeks compared to the bupivacaine-only group. Conclusion: Epidural interlaminar injection of corticosteroid combined with bupivacaine provides significantly superior pain relief, functional improvement, and reduced need for repeated analgesic consumption compared to epidural interlaminar bupivacaine alone in patients with intervertebral disc prolapse.