Patients' expectations and experience of caudal epidural injections

  • Research type

    Research Study

  • Full title

    Patients' expectations and experience of caudal epidural injections - a qualitative evaluation of caudal epidural injections in patients over sixty-five years with a diagnosis of neurogenic claudication, with a view to identifying patient related outcomes.

  • IRAS ID

    138006

  • Contact name

    Selwyn Richards

  • Contact email

    Selwyn.Richards@poole.nhs.uk

  • Sponsor organisation

    Poole Hospital NHS Foundation Trust

  • Duration of Study in the UK

    1 years, 6 months, 0 days

  • Research summary

    Neurogenic claudication is a clinical syndrome characterised by pain and numbness that spreads from the buttocks and down the legs on walking often with transient leg weakness, relieved by sitting. It is a common condition associated with substantial disability and healthcare costs. It is usually caused by spinal stenosis, a pathological narrowing of the lumbar spinal canal which can be diagnosed with a MRI scan. The majority of patients are over 60 years and have stenosis related to degenerative changes in the intervertebral discs and adjacent structures. The definitive treatment for neurogenic claudication is surgery but the techniques are complex and carry a significant peri-operative risk particularly in elderly patients with multiple co-morbidities. Therefore, conservative treatments such as physiotherapy and caudal epidural injections are usually tried before surgery is considered. A caudal epidural injection is a simple and safe procedure carried out under local anaesthetic.
    Caudal Epidurals are used in the management of this patient group at Poole Hospital. While it is our experience that a significant proportion of patients derive benefit, the literature is limited. We would like to further evaluate the effects of epidural injections with a future randomised clinical trial. The study described here is an initial attempt to identify patient reported outcome measures (PROMs) that could be used in a larger trial.
    Data will be collected through focus groups and telephone interviews. There will be two groups of service users, one group who are waiting to start their treatment with data collected before and after them receiving the caudal epidural. The second of participants who are receiving caudal epidurals on a regular basis. Data will be transcribed from audio recordings, analysed and relevant PROMs identified. The project will be written up for submission to a peer review heath care journal.

  • REC name

    South Central - Hampshire B Research Ethics Committee

  • REC reference

    14/SC/1227

  • Date of REC Opinion

    9 Oct 2014

  • REC opinion

    Further Information Favourable Opinion