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
Neurological Deficit Post Transforaminal Epidural Steroid Injection in a Patient with Degenerative Lumbar Scoliosis and Spinal Stenosis
