scholarly journals Follow-up of at least five years after lumbar transforaminal epidural steroid injection for radicular pain due to lumbar disc herniation

2020 ◽  
Vol 9 (1) ◽  
pp. 116-118 ◽  
Author(s):  
Seung Hwa Jang ◽  
Min Cheol Chang
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Steroid Injection ◽  
Lumbar Disc ◽  
Radicular Pain ◽  
Epidural Steroid Injection ◽  
Transforaminal Epidural Steroid Injection ◽  
Epidural Steroid

scholarly journals Clinical Evaluation of Transforaminal Epidural Steroid Injection in Patients with Gadolinium Enhancing Spinal Nerves Associated with Disc Herniation

2015 ◽  
Vol 2;18 (2;3) ◽  
pp. E177-E185
Author(s):  
Sang-Ho Ahn
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Steroid Injection ◽  
Lumbar Disc ◽  
Radicular Pain ◽  
Epidural Steroid Injection ◽  
Enhanced Mri ◽  
Contrast Enhanced ◽  
Transforaminal Epidural Steroid Injection ◽  
Epidural Steroid

Background: Transforaminal epidural steroid injection (TFESI) of corticosteroid is frequently employed to mitigate the painful and disabling symptoms of lumbar disc herniation. However, the treatment outcome of TFESI in patients with radicular pain and inflamed neural structures as assessed by contrast-enhanced magnetic resonance imaging (MRI) has not been forthcoming. Objectives: To investigate functional improvement and pain reduction following TFESI in patients found to have nerve inflammation as evidenced by gadolinium-enhanced (MRI). Study Design: Retrospective assessment. Setting: Tertiary spinal intervention center, Daegu, Korea. Methods: Thirty-seven patients were selected by strict inclusion criteria. Patients were classified into enhancing and non-enhancing groups as evidenced by gadolinium-enhanced MRI. The enhancing group was further divided into pre-dorsal roog ganglion (DRG) only enhanced group and pre-DRG and post-DRG enhanced group. Clinical outcomes were evidenced by numeric rating scale (NRS) and Oswestry disability index (ODI) at pretreatment, one week, and 4 weeks after treatment. Results: The improvement of NRS and ODI in the enhanced group was greater than those of the non-enhanced group, at one week and 4 weeks after TFESI (P < 0.05). However there was no significant difference in improvement of NRS and ODI between pre-DRG only enhanced group and pre-DRG and post-DRG enhanced group at one week and 4 weeks after TFESI. Limitations: Retrospective chart review with a small sample size. Conclusion: The improvement of NRS and ODI in the enhanced group was significantly greater than those of the non-enhanced group after TFESI. Radicular pain and functional impairment in the presence of gadolinium enhancing spinal neural structures and lumbar disc herniation may be more responsive to TFESI than patients without enhancing neural structures. Key words: Transforaminal epidural steroid injection, radicular pain, herniated lumbar disc, spinal nerve enhancement, contrast enhanced MRI

scholarly journals Transforaminal Epidural Steroid Injection Combined with Radio Frequency for the Treatment of Lumbar Disc Herniation: A 2-year Follow-up

2020 ◽  
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, 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.

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

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.

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

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.

scholarly journals Resorption of Massive Lumbar Disc Herniation on MRI Treated with Epidural Steroid Injection: A Retrospective Study of 28 Cases

2016 ◽  
Vol 6;19 (6;7) ◽  
pp. 381-388 ◽  
Author(s):  
Sang Soo Kang
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Steroid Injection ◽  
Lumbar Disc ◽  
Epidural Steroid Injection ◽  
Herniated Disc ◽  
Transforaminal Epidural Steroid Injection ◽  
C Value ◽  
The Mean ◽  
Epidural Steroid

Background: Although herniated disc fragments may resolve spontaneously, the optimal treatment option for massive lumbar disc herniation (LDH) has not been determined. Objective: To evaluate the extent of reduction in the size of massive LDH on magnetic resonance imaging (MRI) and the pain relief effect of transforaminal epidural steroid injection (TFESI) during the study period. Study Design: Retrospective evaluation. Setting: Hospital and ambulatory pain clinic, Korea. Methods: After Institutional Review Board approval, we conducted a retrospective review of 28 patients who underwent at least 2 MRIs during the period from January 2012 to December 2014. The size of the herniated mass was determined from the ratio of the anterior-posterior diameter of the spinal canal (C-value) to the maximum anterior-posterior diameter of the herniated disc (H-value) on axial MRI (C-H ratio). We also analyzed visual analogue scale (VAS) scores at baseline (T0), 2 weeks after the first and second TFESI (T1, T2), and at the second follow-up MRI (T3). Results: The mean C-value was 18.3 ± 2.9 mm. The mean H-value changed from 10.4 ± 1.9 mm to 4.5 ± 2.7 mm, and the mean C-H ratio changed from 58 ± 1.0% to 24 ± 1.4% (P < 0.001). Twenty-four of 28 patients demonstrated a reduction in the size of the herniation, and the mean reduction rate of the C-H ratio was 59%. In 4 patients, the LDH had not resolved on MRI, but the symptoms had diminished to such an extent that surgery was not required. The mean VAS score had significantly decreased at T1 and showed a continued decrease at the time of the last follow-up (P < 0.001). Limitations: This is a retrospective study and only offers data for patients who chose not to undergo surgery. In addition, the timing of repeat MRI was not standardized. Conclusion: The majority of cases of massive LDH demonstrated resolution at variable points between 3 and 21 months. TFESI could provide effective pain relief for patients with massive LDH in the interval without severe neurologic deterioration. IRB approval: Kangdong Sacred Heart Hospital: IRB Number # 14-1-10 Key words: Lumbar disc herniation, magnetic resonance imaging, migration, regression, resorption, sequestration, transforaminal epidural steroid injection

scholarly journals Lumbar Retrodiscal Versus Post-Ganglionic Transforaminal Epidural Steroid Injection for the Treatment of Lumbar Intervertebral Disc Herniations

2011 ◽  
Vol 4;14 (4;7) ◽  
pp. 353-360
Author(s):  
Hahck Soo Park
Keyword(s):  
Pain Score ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Steroid Injection ◽  
Lumbar Disc ◽  
Radicular Pain ◽  
Epidural Steroid Injection ◽  
Vas Score ◽  
Classic Approach ◽  
Epidural Steroid

Background: Lumbar transforaminal epidural steroid injections (TFESIs) are procedures often utilized in the treatment of radicular pain. TFESIs with a preganglionic approach have been reported to be more effective than TFESIs performed using a classic approach. However, it is unknown whether TFESIs using a retrodiscal approach are as effective as other approaches. Objective: To investigate the effect of an epidural steroid injection (ESI) on radicular pain, we conducted a randomized, controlled trial comparing a retrodiscal approach with a classic approach to treat lumbar disc herniation. Design: A case control study. Methods: Forty patients were randomized to receive lumbar TFESIs with either a retrodiscal approach (n=20) or with a classic approach (n=20). Measurements were taken before as well as 4 and 8 weeks after treatment using a visual analog scale (VAS) score, Patient Satisfaction Index (PSI) and the Roland 5-point pain score. Results: In the retrodiscal group, there was a statistically significant improvement in the VAS score after injection compared to baseline. In the classic group, there was a statistically significant improvement in the VAS score after injection compared to baseline. There was no statistically significant difference in the VAS score, PSI, or the Roland 5-point pain score between those treated with a retrodiscal approache and those treated with a classic approach. Limitations: Secondary outcomes were not measured and the study did not include a midor long-term follow-up period. Conclusion: In this study, TFESIs performed using a retrodiscal or classic approach had similar effects on radicular pain. The classic and the retrodiscal transforaminal steroid injection resulted in equivalent pain relief. . Key words: Corticosteroids, lumbar disc herniation, radicular pain, retrodiscal, transforaminal epidural injection

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