This protocol addresses spondylolisthesis in patients who have completed a structured physical therapy program and have not reached the expected clinical targets — persistent low back pain and inadequate improvement in lumbar range of motion trigger escalation to the next treatment step.
A structured physical therapy program lasting at least 3 weeks — incorporating flexion exercises, core stabilization training, and walking-based endurance work — was undertaken with the goals of reducing low back pain and improving lumbar range of motion. Failure to achieve those goals is the escalation trigger for this protocol.
Short-term pain reduction and functional improvement.
DOI: 10.25122/jml-2025-0039
Epidural steroid injections are indicated in patients with symptomatic spondylolisthesis experiencing nerve root irritation, neurogenic claudication due to spinal stenosis, persistent pain despite NSAID use, physical therapy, and activity modification, or those who require temporary pain relief until surgery.
These injections deliver corticosteroids such as methylprednisolone into the epidural space to reduce inflammation and relieve pain.
Studies have demonstrated short-term benefits, including pain reduction and functional improvement, but long-term efficacy remains variable.
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