Comparative efficacy of low-vs high-volume caudal epidural steroid injections in lumbar degenerative disc disease: A systematic review protocol

Background: Lumbar degenerative disc disease (LDDD) is a progressive disorder caused by intervertebral disc dehydration followed by an annulus fibrosis tear, which causes inflammation. As this process progresses, it can cause the loss of disc height, pain, neurological symptoms, and mechanical instability due to the loss of disc height. The prevalence of LDDD increases with age and is a significant contributor to disability and reduced quality of life worldwide. Objective: The major aim of this systematic study is to determine the effectiveness of caudal epidural steroid injection (CESI) in the treatment of lumbar degenerative disc disease (LDDD). Methods: The literature search will do in articles published in the last 20 years (1 January 2004 to 31 December 2024) those published in the English language. For articles published in other languages, English translations were sought if available. A comprehensive search of academic databases such as Scopus, PubMed, Embase, Cochrane and Web of Science using appropriate keywords and Boolean operators will be performed. The present systematic review used a three-phase search strategy. MEDLINE and CINAHL will be searched in the first phase, and the words in the abstract and title as well as the index terms used to describe the article will be analyzed. In the second stage, every recognized keyword and index term is used. The third stage of the literature search was looking for more research in the reference lists of the papers that were found. Expected outcome: The anticipated impact includes guiding clinical decision-making, optimizing CESI protocols, informing guidelines, and identifying evidence gaps for future research in LDDD management.