Evaluating the Effectiveness of Transforaminal Epidural Steroid Injections for Lumbar Radiculopathy Due to a Herniated Nucleus Pulpous Utilizing PROMIS as an Outcome Measure.

Abstract

Objective: The purpose of this study was to evaluate the effect of transforaminal epidural steroid injection (TFESIs) for patients with lumbosacral radiculopathy secondary to a lumbosacral herniated nucleus pulposus (HNP).

Design: A retrospective review of adult patients who received a fluoroscopically guided TSNRI for a HNP was performed. Patient Reported Outcome Measurement Information System (PROMIS) domains of Physical Function (PF), Pain Interference (PI), and Depression (D) were collected at baseline and post-procedure short-term (1-3 months post-procedure) and long-term follow-up (6-12 months post-procedure).

Results: PROMIS PF at short- and long-term follow-up statistically improved by 1.9 (p = 0.02) and 4.6 (p = 0.01) points respectively. PROMIS PI at short- and long-term follow-up statistically improved by 3.7 (p < 0.001) and 5.9 (p - 0.002) points respectively. Depression scores improved by 2.7 (p = 0.04) at short-term follow-up but long-term follow-up scores did not significantly differ from baseline scores. 91 (85%) of patients did not elect for spine surgical consultation.

Conclusions: Our study demonstrated that lumbosacral TFESI was associated with a long-term improvement in function and pain for patients with lumbosacral radiculopathy due to a HNP as measured by PROMIS PF and PI survey and obviated the need for spine surgery at long-term follow-up.