The effect of epidural steroid injection on the natural history of lumbar disc herniation

Abstract Objective: To assess the therapeutic efficacy of transforaminal epidural steroid injection (TFESI) combined with radio frequency (RF) for the treatment of lumbar disc herniation (LDH). Methods: A total of 230 patients participated in the study: TFESI (Group T, n=110), TFESI combined with RF (Group TR, n=120). Visual analogue scale (VAS), Oswestry disability index (ODI) and Global perceived effect (GPE) scale were measured pre-operation, 1, 3, 6, 12 and 24 months after the operation. Hospitalization time, operation time, complications, and recurrence were compared between the two groups.Results: The VAS and ODI at each observation point of the post-operation were significantly decreased compared with the pre-operation in both groups (P < 0.05). There was no statistically different of VAS and ODI between the two groups at 1 and 3 months of the post-operation (P > 0.05). However, The VAS and ODI scores in Group TR were significantly lower than that in Group T at 6, 12 and 24 months of the post-operation (P < 0.05). The GPE in group TR was high in the early days, while that at 1 and 3 month after treatment was significantly higher than that in group T (P < 0.05). The recurrence rate in Group TR was lower than that in Group T (P = 0.002). There was no significant difference of hospitalization time, complications, VAS and ODI score at the pre-operation between the two groups (P > 0.05).Conclusion: These findings suggest that TFESI combined with RF could effectively improve the pain and function, and had a long-term satisfactory effect for the treatment of LDH.

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Transforaminal epidural steroid injection combined with radio frequency for the treatment of lumbar disc herniation: a 2-year follow-up

10.21203/rs.3.rs-50558/v2 ◽

2021 ◽

Author(s):

Wenbo Wei ◽

Shajie Dang ◽

Ling Wei ◽

Tian Liu ◽

Jue Wang

Keyword(s):

Radio Frequency ◽

Lumbar Disc Herniation ◽

Disc Herniation ◽

Steroid Injection ◽

Lumbar Disc ◽

Epidural Steroid Injection ◽

Hospitalization Time ◽

Post Operation ◽

Transforaminal Epidural Steroid Injection ◽

Epidural Steroid

Abstract Objective: To assess the therapeutic efficacy of transforaminal epidural steroid injection (TFESI) combined with radio frequency (RF) for the treatment of lumbar disc herniation (LDH). Methods: A total of 230 patients participated in the study: TFESI (Group T, n=110), TFESI combined with RF (Group TR, n=120). Visual analogue scale (VAS), Oswestry disability index (ODI) and Global perceived effect (GPE) scale were measured pre-operation, 1, 3, 6, 12 and 24 months after the operation. Hospitalization time, treatment time, complications, and recurrence were compared between the two groups.Results: The VAS and ODI at each observation point of the post-operation were significantly decreased compared with the pre-operation in both groups (P < 0.05). There was no statistically difference of VAS and ODI between the two groups at 1 and 3 months of the post-operation (P > 0.05). However, The VAS and ODI scores in Group TR were significantly lower than that in Group T at 6, 12 and 24 months of the post-operation (P < 0.05). The GPE in group TR was high in the early days, while that at 1 and 3 months after treatment was significantly higher than that in group T (P < 0.05). The recurrence rate in Group TR was lower than that in Group T (P = 0.002). There was no significant difference in hospitalization time, complications, VAS and ODI score at the pre-operation between the two groups (P > 0.05).Conclusion: These findings suggest that TFESI combined with RF could effectively improve the pain and function, and had a long-term satisfactory effect for the treatment of LDH.

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Paraplegia after transforaminal epidural steroid injection in a patient with severe lumbar disc herniation - A case report -

Anesthesia and Pain Medicine ◽

10.17085/apm.20068 ◽

2021 ◽

Vol 16 (1) ◽

pp. 96-102

Author(s):

Seok Ho Jeon ◽

Won Jang ◽

Sun-Hee Kim ◽

Yong-Hyun Cho ◽

Hyun Seok Lee ◽

...

Keyword(s):

Lumbar Disc Herniation ◽

Disc Herniation ◽

Steroid Injection ◽

Treatment Plan ◽

Lumbar Disc ◽

Cauda Equina ◽

Epidural Steroid Injection ◽

Correct Treatment ◽

Transforaminal Epidural Steroid Injection ◽

Epidural Steroid

Background: Transforaminal epidural steroid injection (TFESI) is a conservative treatment for patients with lumbar disc herniation (LDH). However, there are reports of various complications that can occur after TFESI; among these, paraplegia is a serious complication. Case: A 70-year-old woman who was unable to lie supine due to low back pain exacerbation during back extension underwent TFESI. After injection, there was pain relief and the patient was able to lie supine; however, paraplegia developed immediately. Magnetic resonance imaging confirmed cauda equina syndrome (CES) due to nerve compression from L1–2 LDH. We determined that the patient's LDH was already severe enough to be considered CES and that the TFESI procedure performed without an accurate understanding of the patient's condition aggravated the disease. Conclusions: It is important to accurately determine the cause of pain and disease state of a patient to establish a correct treatment plan before TFESI is performed.

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