Study of outcome of fluoroscopic guided transforaminal lumbar epidural steroid injection in patients with low back pain with radiculopathy

Abstract

Objectives: Evaluation of the outcome and the effects of fluoroscopic transforaminal epidural steroid injections in long term in patients having back pain with radicular leg pain. Background Data: Many studies have evaluated the efficacy of traditional trans sacral (caudal) or translaminar (lumbar) administration of epidural steroids, no studies have assessed specifically the therapeutic value of fluoroscopic transforaminal epidural steroids. Study Design: A prospective study that investigated the outcome of patients with radicular leg pain due to lumbar herniated disc who were injected with fluoroscopic transforaminal epidural steroid injections. Methods: All the patients included in our study received contrast-enhanced, fluoroscopically guided, transforaminal epidural injection of steroid at the documented pathological site. Patients’ evaluation was done by the independent observer. All the patients received sequential questionnaires pre-and postinjection, documenting pain, activity, and patient satisfaction. Results: 20 patients taken in this study and follow up taken for an average 52 weeks; 14 patients had a good outcome, reporting at least a >50% reduction between pre-injection and post-injection pain scores, as well as an ability to return to their activity of daily living after only 1.5 injections per patient. Out of 20 patients 16 were happy with their outcomes. Conclusions: Fluoroscopic transforaminal epidural injection of steroids are an effective conservative treatment option for patients with lumbar disc prolapse and radiculopathy when other conservative treatments are not so effective and before undergoing surgical intervention.