The effectiveness of transforaminal epidural steroid injections on radicular pain, functionality, psychological status and sleep quality in patients with lumbar disc herniation
Affiliations: [a] Department of Physical Medicine and Rehabilitation, Dicle University Faculty of Medicine, Diyarbakır, Turkey | [b] Department of Psychiatry, Dicle University Faculty of Medicine,Diyarbakır, Turkey | [c] Department of Neurosurgery, Dicle University Faculty of Medicine,Diyarbakır, Turkey
Correspondence:
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Corresponding author: Mustafa Akif Sariyildiz, Department of Physical Medicine and Rehabilitation, Dicle University Faculty of Medicine, Diyarbakır, Turkey. Tel.: +90 505 7673521; Fax: +90 412 2488523; E-mail:makifsariyildiz@hotmail.com
Abstract: BACKGROUND: The significance of fluoroscopy-guided transforaminal
epidural steroid injections (TFESI) in the treatment of lumbar disc
herniation (LDH) is well known. The aim of our study is to investigate the
effectiveness of TFESI on radicular pain, functionality, psychological
status, and sleep quality in patients with LDH. METHODS: Seventy-five LDH patients (36 males, 39 females) were
enrolled in the study. All patients received a fluoroscopically guided TFESI
(betamethasone 40 mg, lidocaine 2%). Also all patients were evaluated
according to (with the visual analogue scale) radicular pain, Oswestry
disability index (ODI), hospital axiety and depression scale, and Pittsburgh
sleep quality index (PSQI) at baseline, at two weeks, and 12 months post
injections. RESULTS: Mean age was 46.4 ± 12.5. When compared to baseline
measurements there were significant improvements in radicular pain, ODI,
modified schober, Laseque angle, finger to floor distance, depressive
symptoms and PSQI scores at two weeks and 12 months after injection.
Improvement of at least 50% in radicular pain relief, ODI score and sleep
quality index was detected at two weeks 83%, 71%, 69% respectively.
This rate showed regression at 12 months of 73%, 65% and 62%
respectively. Duration of symptoms was significantly negatively correlated
with changes in scores of radicular pain, ODI, depressive symptoms, and
PSQI. There were no significant correlations with symptom duration and
anxious symptoms. CONCLUSION: Fluoroscopy guided TFESI had positive effects on
radicular pain, functionality, depressive symptoms and sleep quality in
management of LDH.
