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Journal of the Korean Academy of Rehabilitation Medicine 2000;24(4):733-740.
Effects of Translaminar Approach and Transforaminal Approach in Lumbar Epidural Steroid Injection.
Kim, Hee Sang , Hong, Jang Hyeok , Ahn, Kyung Hoi , Kim, Yong Gul
1Department of Rehabilitation Medicine, Kyunghee University College of Medicine.
2Department of Rehabilitation Medicine, Joongmun College of Medicine.
요추부 경막외 스테로이드 주사에서 경추궁(經椎弓)법과 경추간공(經椎間孔)법의 효과
김희상, 홍장혁, 안경회, 김용걸1
경희대학교 의과대학 재활의학교실, 1중문의과대학 재활의학교실
Abstract

Objective
The goal of this study was to compare the therapeutic and the functional value between translaminar approach and transforaminal approach of epidural steroid injection in patient with refractory radicular pain.


Method
Among 31 patients with unilateral herniated nucleus pulposus (HNP) which was confirmed by physical examination and magnetic resonance imaging (MRI), 17 patients received a transforaminal approach and 14 patients received a translaminar approach. All patients were evaluated by independent observer and were checked by visual analogue scale (VAS), functional score before and 1 day, 2 weeks and 4 weeks after injection.


Results
The VAS of transforaminal approach was significantly lower than that of translaminar approach after 2 weeks and after 4 weeks (p<0.05), although there were no statistical difference before and 1 day after injection. The functional score of transforaminal approach was significantly higher than that of translaminar approach after 4 weeks (p<0.05), although there were no statistical difference before and 1 day, 2 weeks after injection. The translaminar approach needs more frequent injection (p<0.05).


Conclusion
This study suggests that both translaminar approach and transforaminal approach could be valuable to the initial management of refractory radicular pain, but the duration of therapeutic effects was relatively short in translaminar approach. Transforaminal approach will be the promising treatment of refractory radicular pain, because it has better therapeutic efficacy, safety and longer duration of therapeutic effects than translaminar approach.

Key Words: Translaminar approach, Refractory radicular pain, Epidural steroid injection, Translaminar approach, Transforaminal approach


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