Racz Catheter Technique Versus Conventional Technique in Lumbar Epidural Steroid Injection for Management of Low Back Pain: A Randomized Controlled Trial

Abstract

Background: Epidural steroid injections (ESIs) are widely employed for managing low back pain (LBP), particularly when conservative treatment fails. The Racz catheter technique offers targeted drug delivery and mechanical adhesiolysis, potentially enhancing outcomes in chronic LBP. Objectives: The present study aimed to compare the Racz catheter technique and the conventional technique in lumbar epidural steroid injection for the management of LBP. Methods: This randomized, controlled, double-blind study was conducted on a sample of 60 patients, aged 18 - 65, comprising both sexes, who had persistent lumbar pain, grade 1 spondylolisthesis, and facet osteoarthropathy with small disc findings on radiological examination. Participants were randomized equally into two groups. The Racz catheter group received lumbar epidural steroids using a Racz catheter, while the conventional lumbar group received conventional lumbar steroid injections. Results: The Visual Analog Scale (VAS) and Oswestry Low Back Disability Questionnaire (OSW) scores were insignificantly different at baseline, immediately post-procedure, and at 1 month between both groups. However, they were significantly lower at 2 months, 4 months, and 6 months in the Racz catheter group compared to the conventional lumbar group (P < 0.05). Incidences of hypotension, paraesthesia, bleeding, and headache were insignificantly different between both groups. Patient satisfaction levels were significantly higher in the Racz catheter group than in the conventional lumbar group (P < 0.05). Conclusions: The Racz catheter technique is a superior interventional option for lumbar epidural steroid delivery in patients with persistent LBP, providing enhanced pain relief, improved functional outcomes, greater patient satisfaction, and equivalent procedural safety compared to the conventional technique.