An Analysis of the Outcome of Transforaminal Epidural Steroid Injections in Patients with Spinal Stenosis or Herniated Intervertebral Discs

Abstract

Background: Spinal stenosis and herniated intervertebral discs are the principal causes of lumbosacralradiculopathy. This study was conducted to compare the therapeutic value and duration of pain relief offluoroscopic guided transforaminal epidural steroid injections (TFESIs) in patients with refractory radicular leg pain.Methods: Between August 2006 and March 2007, 87 patients (H group: patients with herniated intervertebraldisc, S group: patients with spinal stenosis) who met the inclusion criteria were treated with fluoroscopic guidedTFESIs. Prior to treatment, the VAS and ODI scores were determine to evaluate the degree of pain and levelof disability. The degree of pain relief was then assessed 1 month after treatment with the TFESIs and gradedas excellent (no residual pain), good (improvement of pain symptoms by more than 50%), fair (improvement ofpain symptoms by less than 50%) and Poor (no improvement of pain), In addition, the duration of pain reliefwas evaluated by regular outpatient visits for 6 months, and by telephone interviews after 6 months.Results: The H and S group both had excellet results at 1 month after treatment with TFESIs showingimprovements of 44.1 % and 20.8% respectively, However this difference was not significant between groups.In addition, a duration of pain relief greater than 6 months was achieved in 32.4% of the patients in the H groupand 37.7% of those in the S grouP.Conclusions: TFESIs had a similar degree of therapeutic effectiveness and duration of pain relief in patientswith spinal stenosis and herniated intervertebral discs. (Korean J Pain 2008; 21: 38-43)