200 Section - Adjunctive Use of GLP-1 Receptor Agonists to Enhance Epidural Injection Outcomes in Lumbar Spinal Stenosis: A Case Report

      We present the case of a 69-year-old patient with a history of chronic LSS unresponsive to conventional treatments. Trials of muscle relaxants, Tylenol, Tizanidine, Lyrica, physical therapy, and left L3 and L4 transforaminal epidural steroid injections (TFESI) provided negligible improvement in pain and function. A course of Tirzepatide was initiated, resulting in a 10-pound weight reduction over one month. Following this intervention, the patient underwent a repeat L3 and L4 TFESI, which led to an 80% improvement in pain symptoms and enhanced functional capacity at 6-week follow-up.

Discussions:

      This case suggests a potential synergistic effect between GLP-1 RA treatment and the efficacy of TFESI in patients with LSS. It is possible that both the anti-inflammatory effects and weight loss associated with GLP-1 RAs contributed to this positive outcome. Those are both known effects of GLP-1 RAs as well as factors that are known to improve musculoskeletal pain.

Conclusions:

      GLP-1 RAs may enhance the clinical outcomes of TFESI in patients with LSS where GLP-1 RAs are already indicated. Further research is warranted to explore the therapeutic potential of GLP-1 RAs as adjunctive agents in pain management strategies in musculoskeletal conditions.