The effectiveness of transforaminal epidural steroid injection in patients with radicular low back pain due to lumbar disc herniation two years after treatment

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Article type: Research Article

Authors: Taskaynatan, Mehmet Ali^a | Tezel, Kutay^a | Yavuz, Ferdi^{b; *} | Tan, Arif Kenan^a

Affiliations: [a] Department of Physical Medicine and Rehabilitation, Gülhane Military Medical Academy, TAF Rehabilitation Center, Ankara, Turkey | [b] Clinic of Physical Medicine and Rehabilitation, Military Hospital of Etimesgut, Ankara, Turkey

Correspondence: [*] Corresponding author: Ferdi Yavuz, Clinic of Physical Medicine and Rehabilitation, Military Hospital of Etimesgut, Ankara, Turkey. Tel.: +90 312 346 13 11, +90 544 343 54 58; Fax: +90 312 291 10 09; E-mail:ferdiyavuz@yahoo.com

Abstract: BACKGROUND AND AIM: The aim of this retrospective study was to investigate the therapeutic effect of transforaminal epidural steroid injection in patients with chronic low back pain and radicular leg pain due to lumbar disc herniation. MATERIALS AND METHODS: This study included 80 patients (32 female and 48 male; mean age: 45.8 years [range: 25-65 years]) that received fluoroscopically guided transforaminal epidural steroid injections for chronic radicular low back pain due to lumbar disc herniation. All of the patients had diagnostic MRI findings and did not respond to conservative treatment. All injections were performed by the same physician at the interventional pain unit of a tertiary hospital. The effectiveness of transforaminal epidural steroid injections was assessed via a standardized telephone questionnaire administered 2 years after the first injection. RESULTS: Mean duration of radicular low back pain was 24.50 ± 18.25 months. Most of the epidural injections were administered at the L5 and S1 levels. The most effective post-injection period was the first 5.11 ± 3.07 months. Mean duration of injection effect was 12.46 ± 7.24 months. The response rate to the epidural steroid injections was 72%. CONCLUSIONS: There was negative correlation between the duration of treatment effect and the duration of pre-treatment symptoms. Additionally, clinical improvement of radicular low back pain increased significantly as the duration of pre-treatment symptoms decreased. Based on the present findings, we think that transforaminal epidural steroid injections can be used as an alternative treatment for managing chronic radicular low back pain.

Keywords: Low back pain, epidural steroids, transforaminal, radiculopathy

DOI: 10.3233/BMR-140539

Journal: Journal of Back and Musculoskeletal Rehabilitation, vol. 28, no. 3, pp. 447-451, 2015