Contralateral Lumbar Radicular Pain Shortly After a Transforaminal Epidural Steroid Injection

2014 ◽  
Vol 93 (9) ◽  
pp. 834-835 ◽  
Author(s):  
Osman Hakan Gündüz ◽  
Uzma Akhlaque ◽  
Savas Sencan ◽  
Alp Eren Celenlioglu ◽  
Askin Seker
Keyword(s):  
Steroid Injection ◽  
Radicular Pain ◽  
Epidural Steroid Injection ◽  
Transforaminal Epidural Steroid Injection ◽  
Lumbar Radicular Pain ◽  
Epidural Steroid

scholarly journals Outcome of Transforaminal Epidural Steroid Injection According to the Severity of Lumbar Foraminal Spinal Stenosis

2018 ◽  
Vol 1 (21;1) ◽  
pp. 67-72 ◽  
Author(s):  
Min Cheol Chang, MD Chang
Keyword(s):  
Spinal Stenosis ◽  
Rating Scale ◽  
Steroid Injection ◽  
Radicular Pain ◽  
Epidural Steroid Injection ◽  
University Hospital ◽  
Group A ◽  
Transforaminal Epidural Steroid Injection ◽  
Lumbar Radicular Pain ◽  
Epidural Steroid

Background: Lumbar foraminal spinal stenosis (LFSS) is a common cause of radicular pain in the lower extremities. Transforaminal epidural steroid injection (TFESI) is being used widely for controlling radicular pain induced by LFSS. The efficacy of TFESI has been demonstrated in previous studies. However, no study has evaluated the outcome of TFESI according to the severity of LFSS. Objective: In this study, we evaluated the outcome of TFESI in patients with chronic lumbar radicular pain due to LFSS according to the severity of LFSS by using magnetic resonance imaging (MRI). Study Design: A prospective observational study. Setting: A university hospital. Methods: Sixty patients with chronic lumbar radicular pain due to LFSS were included in this prospective study and received TFESI at our university hospital. Three patients were lost to followup. On the basis of sagittal lumbar MRI findings, we assigned patients with mild to moderate LFSS to group A (n = 31) and those with severe LFSS to group B (n = 26). Pain intensity was evaluated using a numeric rating scale (NRS) before treatment and at 1, 2, and 3 months after treatment. Results: Compared to pretreatment NRS scores, a significant decrease in NRS scores was observed in patients in both groups at 1, 2, and 3 months after treatment (P = 0.000). However, reductions in the NRS scores over time were significantly larger in group A (P = 0.023). Three months after treatment, 27 patients (87.1%) in group A and 11 patients (42.3%) in group B reported successful pain relief (pain relief of ≥ 50%). Limitations: This study had a small number of patients. Conclusions: After TFESI, chronic lumbar radicular pain was significantly reduced regardless of the severity of LFSS, and the effects of TFESI were sustained for at least 3 months after treatment. However, the outcome of TFESI was superior in the group with a mild to moderate degree of LFSS, compared to the group with a severe degree of LFSS. We believe that our study provides useful information for establishing a treatment plan for radicular pain due to LFSS. Key words: Lumbar foraminal spinal stenosis, transforaminal epidural steroid injection, disease severity, magnetic resonance imaging, numeric rating scale, corticosteroids

scholarly journals The Effectiveness of Fluoroscopically Guided Cervical Transforaminal Epidural Steroid Injection for the Treatment of Radicular Pain; a Systematic Review and Meta-analysis

Pain Medicine ◽  
2019 ◽  
Vol 21 (1) ◽  
pp. 41-54 ◽  
Author(s):  
Aaron Conger ◽  
Daniel M Cushman ◽  
Rebecca A Speckman ◽  
Taylor Burnham ◽  
Masaru Teramoto ◽  
...  
Keyword(s):  
Systematic Review ◽  
Comparison Group ◽  
Steroid Injection ◽  
Meta Analysis ◽  
Standard Of Care ◽  
Response Rates ◽  
Radicular Pain ◽  
Epidural Steroid Injection ◽  
Transforaminal Epidural Steroid Injection ◽  
Epidural Steroid

Abstract Objective Determine the effectiveness of fluoroscopically guided cervical transforaminal epidural steroid injection (CTFESI) for the treatment of radicular pain. Design Systematic review and meta-analysis. Subjects Persons aged ≥18 years with cervical radicular pain due to disc herniation or degenerative spondylosis. Comparison Sham, placebo procedure, or active standard of care treatment, excluding alternative versions of epidural steroid injection. Outcomes The primary outcome measure was patient-reported improvement in pain of at least 50% from baseline, assessed four or more weeks after the treatment intervention. Secondary outcomes included validated functional assessment tools and avoidance of spinal surgery. Methods Randomized or nonrandomized comparative studies and nonrandomized studies without internal control were included. Three reviewers independently assessed publications in the Medline, PubMed, and Cochrane databases up to July 2018. The Grades of Recommendation, Assessment, Development and Evaluation (GRADE) system was used to evaluate risk of bias and overall quality of evidence. A meta-analysis was conducted for comparative measures of effect and for within-group response rates if applicable. Results There were no studies with an internal comparison group (control group) meeting the review’s definition of comparison group. Therefore, comparative measures of effect were not calculated. In cohort studies, pooled response rates were 48% (95% confidence interval [CI] = 34–61%) at one month and 55% (95% CI = 45–64%) at three months. Conclusions Approximately 50% of patients experience ≥50% pain reduction at short- and intermediate-term follow-up after CTFESI. However, the literature is very low quality according the GRADE criteria, primarily due to a lack of studies with placebo/sham or active standard of care control comparison groups.

Sign in / Sign up

Export Citation Format

Share Document