Quality of Life and Functional Outcomes after Caudal Epidural Steroid Injection Versus Selective Nerve Root Block in Chronic Low Back Pain: A Single-Center Retrospective Cohort Study

Purpose To compare the quality of life and functional outcomes of Caudal Epidural Steroid Injection (CESI) versus Selective Nerve Root Block (SNRB) in chronic low back pain patients, including those who refuse or not eligible for spine surgery. Methods A retrospective cohort study was conducted in Ulin General Hospital for patients who suffered from chronic low back pain and underwent CESI and/or SNRB between January 2020 to December 2024. 90 patients were included in this study. The patient’s pain intensity using VAS, and health-related quality of life after intervention using the SF-36 questionnaire were analyzed. Results 33 male and 57 female patients with mean age 51.38 years ± 11.27 SD were included in this study. The patients were classified into 3 groups: 42 patients (46.67%) received CESI, 6 patients (6,67%) received SNRB only, and 42 patients (46.67%) received both CESI and SNRB. The mean VAS before & after intervention was 8.26 ± 1.4 SD and 3.50 ± 1.64 SD. There was a statistically significant difference in VAS scores before and after intervention (p-value < 0.001). However, there was no significant difference among each group of intervention (p = 0.169). For quality of life and functional outcome, there was significant difference in physical functioning (p = 0.01), energy/fatigue (p < 0.001), emotional well-being (p = 0.001) and pain (p = 0.002) between each group. Conclusion There was significant reduction in pain intensity across all groups, but the specific intervention types (CESI, SNRB, or both) did not significantly differ. Differences in quality-of-life measurement, particularly in physical functioning, energy/fatigue, emotional well-being and pain were noted between each group. Therefore, CESI and SNRB remain valuable treatment modalities for LBP patients who refuse or not eligible for spine surgery.