Effect of Relative Injectate Pressures on the Efficacy of Lumbar Transforaminal Epidural Steroid Injection in Patients with Lumbar Foraminal Stenosis

Abstract

Transforaminal epidural steroid injections (TFESIs) are often used to treat lumbar foraminal stenosis. Injectate pressure (of contrast) was monitored during fluoroscopically guided TFESI to assess the effect on short-term pain reduction. A total of 40 patients underwent single-level lumbar TFESI for unilateral lumbar radicular pain ascribed to foraminal stenosis. Relative injectate pressure of contrast epidurography during TFESI was recorded and compared with pre- and postprocedural pain levels using the Roland 5-point pain scoring method. Pain relief achieved after TFESI revealed no statistically significant correlation with injectate pressure (mean 13.0 cm H2 O). Mean pressures in patients with and without demonstrable pain reduction were 12.9 and 13.2 cm H2 O, respectively. Secondary outcomes were not measured, and no mid- or long-term follow-up was conducted. In this setting, relative injectate pressures had no significant effect on immediate outcomes of TFESI.