TRANSFORAMINAL LUMBAR EPIDURAL STEROID INJECTION FOR LOW BACK PAIN WITH RADICULOPATHY. PATIENTS RELATED 1-YEAR OUTCOMES

Asad Ullah Jan; Abd ullah khan; Sajjad Ahmad; Sajjad khan; Sibghat ullah; Shahab ullah

doi:10.46903/gjms/23.1.1812

TRANSFORAMINAL LUMBAR EPIDURAL STEROID INJECTION FOR LOW BACK PAIN WITH RADICULOPATHY. PATIENTS RELATED 1-YEAR OUTCOMES

Asad Ullah Jan, Abd ullah khan, Sajjad Ahmad, Sajjad khan, Sibghat ullah, Shahab ullah

Abstract

Background: Low back pain with radiculopathy, often resulting from intervertebral disc herniation, significantly impairs quality of life and functions. This study evaluated the efficacy of transforaminal lumbar epidural steroid injections (TFESIs) in providing relief to patients suffering from radiculopathy over a one-year follow-up period.

Materials & Methods: An observational, analytical study was conducted on 21 patients aged 25 to 56 yrs. with radiculopathy, confirmed by MRI and unresponsive to conservative treatments, receiving TFESIs at MTI, DHQ Bannu from March 2023 to Sep. 2023. Pain levels were evaluated using a numerical rating scale (NRS), and functional ability was assessed with the Oswestry Disability Index (ODI). Patient satisfaction was measured through the Patient Satisfaction Questionnaire (PSQ).

Results: The study analyzed the outcomes of 21 patients undergoing treatment for lumbar disc issues revealed significant improvements in pain and functional ability. The patients, with an age range of 25 to 56 and an almost equal sex distribution, showed substantial reductions in pain (NRS scores) and disability (ODI scores) post-treatment. While most patients expressed high satisfaction with the treatment, 38 % continued to use opioids, highlighting the need for ongoing pain management. Additionally, approximately 19% of patients required further surgical interventions.

Conclusions: TFESIs appear to be an effective non-surgical intervention for patients with low back pain and radiculopathy due to disc herniation, leading to significant pain reduction and improved function. However, more extensive, multi-center randomized trials are needed to confirm these findings and evaluate the long-term safety and efficacy of this treatment approach.

Keywords

Transforaminal; Steroid Injection; Radiculopathy; Back; Pain; Lumbar; Disc.

Full Text:

PDF

References

Smith CC, McCormick ZL, Mattie R, MacVicar J, Duszynski B, Stojanovic MP. The effectiveness of lumbar transforaminal injection of steroid for the treatment of radicular pain: a comprehensive review of the published data. Pain Med. 2020;21(3):472–87. https://doi.org/10.1093/pm/pnz160

Kim EJ, Chotai S, Schneider BJ, Sivaganesan A, McGirt MJ, Devin CJ. Effect of depression on patient-reported outcomes following cervical epidural steroid injection for degenerative spine disease. Pain Med. 2018;19(12):2371–6. https://doi.org/10.1093/pm/pny196

Makkar JK, Gourav KKP, Jain K. Transforaminal versus lateral parasagittal versus midline interlaminar lumbar epidural steroid injection for management of unilateral radicular lumbar pain: a randomized double-blind trial. Pain Physician. 2019;22(6):561–73. https://doi.org/10.36076/ppj/2019.22.561

Kennedy DJ, Zheng PZ, Smuck M, McCormick ZL, Huynh L, Schneider BJ. A minimum of 5-year follow-up after lumbar transforaminal epidural steroid injections in patients with lumbar radicular pain due to intervertebral disc herniation. Spine J. 2018;18(1):29–35. https://doi.org/10.1016/j.spinee.2017.08.264

Lee JH, Lee JH, Chang MC. Transforaminal epidural steroid injection for patients with lumbosacral disc herniation in the absence of spine magnetic resonance imaging - is better really the enemy of the best? J Pain Res. 2023;16:1477–85. https://doi.org/10.2147/JPR.S402405

House LM, Barrette K, Mattie R, McCormick ZL. Cervical epidural steroid injection: techniques and evidence. Phys Med Rehabil Clin N Am. 2018;29(1):1–17. https://doi.org/10.1016/j.pmr.2017.08.001

Rafati A, Ghanaati H, Asadi B, Mehrabi F, Rahmatian A, Hassani S. Outcomes of the fluoroscopically-guided vs. computed-tomography-guided transforaminal epidural steroid injection in low back pain: a propensity-matched prospective cohort. Med J Islam Repub Iran. 2023;37:23. https://doi.org/10.47176/mjiri.37.23

Senkal S, Sir E. Comparison of ultrasonography and conventional fluoroscopy guided caudal epidural injection in chronic low back pain. Turk Neurosurg. 2021;31(1):119–23. https://doi.org/10.5137/1019-5149.JTN.31515-20.2

Jang JH, Lee WY, Kim JW, Cho KR, Nam SH, Park Y. Ultrasound-guided selective nerve root block versus fluoroscopy-guided interlaminar epidural block versus fluoroscopy-guided transforaminal epidural block for the treatment of radicular pain in the lower cervical spine: a retrospective comparative study. Pain Res Manag. 2020;2020:9103421. https://doi.org/10.1155/2020/9103421

Soni P, Punj J. Ultrasound-guided lumbar transforaminal epidural injection: a narrative review. Asian Spine J. 2021;15(2):261–70. https://doi.org/10.31616/asj.2019.0245

Arici T, Kurçaloğlu M, Eyıgor C, Uyar M. Transforaminal epidural steroid injection and infraneural approach. Agri. 2019;31(2):104–6.

Wongjarupong A, Pairuchvej S, Laohapornsvan P, Kotheeranurak V, Jitpakdee K, Yeekian C, et al. "Platelet-rich plasma" epidural injection an emerging strategy in lumbar disc herniation: a randomized controlled trial. BMC Musculoskelet Disord. 2023;24(1):335. https://doi.org/10.1186/s12891-023-06429-3

DOI: https://doi.org/10.46903/gjms/23.1.1812