Annals of Rehabilitation Medicine

"Transforaminal epidural steroid injection"

Original Articles

Efficacy of Epidural Neuroplasty Versus Transforaminal Epidural Steroid Injection for the Radiating Pain Caused by a Herniated Lumbar Disc: Hae Jong Kim, Byeong Cheol Rim, Jeong-Wook Lim, Noh Kyoung Park, Tae-Wook Kang, Min Kyun Sohn, Jaewon Beom, Sangkuk Kang; Ann Rehabil Med 2013;37(6):824-831. Published online December 23, 2013; DOI: https://doi.org/10.5535/arm.2013.37.6.824

Abstract
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Objective

To compare the treatment effects of epidural neuroplasty (NP) and transforaminal epidural steroid injection (TFESI) for the radiating pain caused by herniated lumbar disc.

Methods

Thirty-two patients diagnosed with herniated lumbar disc through magnetic resonance imaging or computed tomography were included in this study. Fourteen patients received an epidural NP and eighteen patients had a TFESI. The visual analogue scale (VAS) and functional rating index (FRI) were measured before the treatment, and at 2 weeks, 4 weeks and 8 weeks after the treatment.

Results

In the epidural NP group, the mean values of the VAS before the treatment, and at 2 weeks, 4 weeks and 8 weeks after the treatment were 7.00±1.52, 4.29±1.20, 2.64±0.93, 1.43±0.51 and those of FRI were 23.57±3.84, 16.50±3.48, 11.43±2.44, 7.00±2.15. In the TFESI group, the mean values of the VAS before the treatment, and at 2 weeks, 4 weeks and 8 weeks after the treatment were 7.22±2.05, 4.28±1.67, 2.56±1.04, 1.33±0.49 and those of FRI were 22.00±6.64, 16.22±5.07, 11.56±4.18, 8.06±1.89. During the follow-up period, the values of VAS and FRI within each group were significantly reduced (p<0.05) after the treatment. But there were no significant differences between the two groups statistically.

Conclusion

Epidural NP and TFESI are equally effective treatments for the reduction of radiating pain and for improvement of function in patients with a herniated lumbar disc. We recommend that TFESI should be primarily applied to patients who need interventional spine treatment, because it is easier and more cost-effective than epidural NP.

Citations

Citations to this article as recorded by

Effectiveness of intradiscal ozone injections for treating pain following herniated lumbar disc: A systematic review and meta-analysis
Min Cheol Chang, Yoo Jin Choo, Isabelle Denis, Christopher Mares, Carl Majdalani, Seoyon Yang
Journal of Back and Musculoskeletal Rehabilitation.2024; 37(5): 1131. CrossRef
Comparison of Clinical Effects and Physical Examination of Transforaminal and Caudal Steroid Injection With Targeted Catheter in Lumbar Radiculopathy: A Single‐Blind Randomized Clinical Trial
Farnad Imani, Faezeh Mohammad‐Esmaeel, Seyedeh‐Fatemeh Morsalli, Ali Ahani‐Azari, Mahzad Alimian, Nasim Nikoubakht, Azadeh Emami
Brain and Behavior.2024;[Epub] CrossRef
EVALUATION OF THE EFFICACY OF PERCUTANEOUS CAUDAL AND COMBINED CAUDAL/TRANSFORAMINAL NEUROPLASTY-ADESIOLYSIS FOR TREATING SYMPTOMATIC LUMBAR SPINAL STENOSIS
Mehmet Osman Akçakaya, Alparslan Aşır, Savaş Çömlek
Journal of Turkish Spinal Surgery.2023; 34(2): 61. CrossRef
Percutaneous epidural balloon neuroplasty: a narrative review of current evidence
Doo-Hwan Kim, Jin-Woo Shin, Seong-Soo Choi
Anesthesia and Pain Medicine.2022; 17(4): 361. CrossRef
Comparison of Clinical Results between Percutaneous Epidural Neuroplasty and Trans-Foraminal Epidural Block for Lumbar Foraminal Stenosis
Seung-Woo Shim, Min-Young Kim, Young-Jae Kim, Yong-Soo Choi
Journal of Korean Society of Spine Surgery.2022; 29(4): 107. CrossRef
Nonsurgical treatments for patients with radicular pain from lumbosacral disc herniation
Jung Hwan Lee, Kyoung Hyo Choi, Seok Kang, Dong Hwan Kim, Du Hwan Kim, Bo Ryun Kim, Won Kim, Jung Hwan Kim, Kyung Hee Do, Jong Geol Do, Ju Seok Ryu, Kyunghoon Min, Sung Gin Bahk, Yun Hee Park, Heui Je Bang, Kyoung-ho Shin, Seoyon Yang, Hee Seung Yang, Seu
The Spine Journal.2019; 19(9): 1478. CrossRef
Factors Associated with Successful Response to Balloon Decompressive Adhesiolysis Neuroplasty in Patients with Chronic Lumbar Foraminal Stenosis
Yul Oh, Doo-Hwan Kim, Jun-Young Park, Gyu Yeul Ji, Dong Ah Shin, Sang Won Lee, Jin Kyu Park, Jin-Woo Shin, Seong-Soo Choi
Journal of Clinical Medicine.2019; 8(11): 1766. CrossRef
The effect of additional transforaminal epidural blocks on percutaneous epidural neuroplasty with a wire-type catheter
Ho Young Gil, Sook Young Lee, Sang Kee Min, Ji Eun Kim, Hye Seon Lee, Hae Won Jeong, Bumhee Park, Jinhee Choung, Jong Bum Choi
Medicine.2019; 98(50): e18233. CrossRef
Epidural neuroplasty/epidural adhesiolysis
Se Hee Kim, Sang Sik Choi
Anesthesia and Pain Medicine.2016; 11(1): 14. CrossRef
Safety of Epidural Corticosteroid Injections
Ippokratis Pountos, Michalis Panteli, Gavin Walters, Dudley Bush, Peter V. Giannoudis
Drugs in R&D.2016; 16(1): 19. CrossRef

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Efficacy of Transforaminal Epidural Steroid Injections According to Nerve Root Enhancement.: Do, Sung Jin , Ahn, Sang Ho , Cho, Yun Woo , Shim, Dae Seop , Cho, Hee Kyung , Kim, Han Seon , Jang, Sung Ho; J Korean Acad Rehabil Med 2010;34(2):204-208.

Abstract
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Objective
To determine the efficacy of transforaminal epidural steroid injections according to nerve root enhancement in lumbar disc herniations. Method: Twenty seven patients who had extruded or seques tered lumbar disc herniations on enhanced MR imaging were investigated: fifteen patients with corresponding nerve root enhancement (enhanced group), and twelve patients without enhancement (non-enhanced group). All patients received transforaminal epidural steroid injection. Clinical outcomes were measured by visual analogue scale (VAS) for back and radicular pain, Oswestry disability index (ODI) before treatment and one month after injection. Results: The averages of VAS for lower extremity and back pain in both groups one month after injection significantly reduced compared to that of pretreatment, respectively (p＜0.001). The amount of decrease in pain in enhanced group was larger than that of non-enhanced group (p＜0.05). The averages of ODI in both group one month after injection significantly reduced compared to that of pretreatment (p＜0.0001), however, there was no difference between the two groups. Conclusion: The nerve root enhancement on contrast-enhanced MR imaging indicates the presence of severe inflammatory reaction of nerve root, which means well-responsiveness to anti-inflammatory treatment such as transforaminal epidural steroid injection, even if patients' symptom is very severe. (J Korean Acad Rehab Med 2010; 34: 204-208)

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Effect of Intensive Conservative Treatment on Extraforaminal Lumbar Disc Herniations - 1 Year Prospective Follow-up Study.: Cho, Yun Woo; J Korean Acad Rehabil Med 2009;33(1):89-93.

Abstract
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Objective
To evaluate the outcomes of intensive conservative treatment on extraforaminal lumbar disc herniations. Method: Twenty five patients with extraforaminal lumbar disc herniations with symptomatic radicular pain were included. Under fluoroscopic guidance, 40 mg of triamcinolone was infused around the nerve root after provocation of patient's usual radicular pain. Lumbosacral dynamic stabilization exercise, thermal and electrical therapy, and education of posture correction were added. The clinical outcomes were measured by visual analogue scale (VAS) and Oswestry disability index (ODI) before treatment, one, three, six, and twelve months after the treatment. After twelve months, patients' satisfaction was classified to four categories: excellent, good, fair, or poor. Four patients were dropped out. Results: Follow-up VAS and ODI significantly decreased since post-treatment one month (p＜0.0001). The average score of VAS for lower extremity and back pain reduced significantly from 6.6, 4.5 at pretreatment to 1.5, 1.9 at 12 months post-treatment, respectively (p＜0.0001). The averages of ODI reduced significantly from 65.4% at pretreatment to 25.4% at post-treatment 12 months (p＜0.0001). In patients' satisfaction, seventeen patients (81.0%) were recorded as excellent or good after post-treatment 12 months. Conclusion: Intensive conservative treatment was effective on patients who underwent extraforaminal lumbar disc herniation. Pain relief and functional improvement sustained for 12 months. (J Korean Acad Rehab Med 2009; 33: 89-93)