Erector Spinae Plane vs Caudal Epidural Steroid in Lumbar Spinal Stenosis Resistant to Conservative Therapy

Inclusion Criteria: Inclusion Criteria * Age between 30 and 80 years * Patients with chronic low back pain (lasting longer than 6 months) * Diagnosis of lumbar spinal stenosis (LSS) confirmed by imaging modalities (CT/MRI) and clinical evaluation * LSS Diagnostic Support Tool Assessment (LSS-DST) score greater than 7 * Patients who did not benefit from previous conservative treatments * Presence of a signed written informed consent form indicating willingness to participate in the study LSS-DST (Lumbar Spinal Stenosis - Diagnostic Support Tool) Scoring System * Age 60-70 years: +1 point * Age over 70 years: +2 points * Absence of Diabetes Mellitus: +1 point * Positive claudication: +3 points * Symptoms aggravated by standing: +2 points * Symptoms relieved by forward flexion: +3 points * Symptoms induced by forward flexion: -1 point * Symptoms induced by lumbar extension: +1 point * Ankle-brachial index ≥ 0.9: +3 points * Abnormal Achilles tendon reflex: +1 point * Positive straight leg raise test: -2 points Exclusion Criteria: History of lumbar epidural steroid injection within the last 6 months or history of major trauma * Known allergy to the study medications (lidocaine hydrochloride, dexamethasone 21-phosphate) or to contrast agents * Presence of unstable chronic medical conditions (e.g., diabetes mellitus, hypertension, chronic obstructive pulmonary disease, heart failure) * Advanced joint limitations preventing mobilization (e.g., hip or knee osteoarthritis) * Hi…