Background: Intervertebral disc herniations are the most common cause of
lumbosacral radiculopathy, and transforaminal epidural steroid injection (TFESI)
is an important tool in treating lumbosacral radiculopathy. But the ideal dose
of corticosteroid in the epidural management of lumbosacral radiculopathy has
yet to be determined.
Objective: The aim of this study was to determine the effective dose of
steroids in TFESI for pain reduction in patients with lumbosacral radiculopathy.
Study Design: A randomized, double blind, controlled trial
Setting: An interventional pain management practice center.
Methods: A total of 160 participants received 2 epidural injections of either 5
mg, 10 mg, 20 mg, or 40 mg of triamcinolone in one week intervals via TFESI.
The degree of participant satisfaction and verbal numerical rating scale (VNRS)
were assessed at pretreatment, one week, and 2 weeks after the first TFESI.
Results: The number of participants experiencing pain relief was significantly
less than in other groups in the 5 mg triamcinolone group at one week after
the first TFESI. There were no significant differences among the groups at one
week after the second TFESI. VNRS decreased in the other groups except the
triamcinolone 5 mg group at one week after the first TFESI. VNRS decreased in
all groups at one week after the second TFESI.
Limitations: The limitations include lack of placebo control group and lack
of long-term follow-up.
Conclusions: We recommend a minimal effective dose of corticosteroid
(triamcinolone 10 mg) in TFESI for patients with lumbosacral radiculopathy.
Key words: herniated disc, steroid, transforaminal epidural steroid injection,
triamcinolone
The Dosages of Corticosteroid in
Transforaminal Epidural Steroid Injections for
Lumbar Radicular Pain Due to a Herniated Disc
