Transforaminal epidural steroid injection combined with radio frequency for the treatment of lumbar disc herniation: a 2-year follow-up

Wen-Bo Wei,Sha-Jie Dang,Tian Liu,Ling Wei,Jue Wang

doi:10.1186/s12891-021-04209-5

Abstract

BackgroundTo assess the therapeutic efficacy of transforaminal epidural steroid injection (TFESI) combined with radio frequency (RF) for the treatment of lumbar disc herniation (LDH).MethodsA total of 230 patients participated in the study: TFESI (Group T, n = 110), TFESI combined with RF (Group TR, n = 120). Visual analogue scale (VAS), Oswestry disability index (ODI) and Global perceived effect (GPE) scale were measured pre-operation, 1, 3, 6, 12 and 24 months after the operation. Hospitalization time, treatment time, complications, and recurrence were compared between the two groups.ResultsThe VAS and ODI at each observation point of the post-operation were significantly decreased compared with the pre-operation in both groups (P < 0.05). There was no statistically difference of VAS and ODI between the two groups at 1 and 3 months of the post-operation (P > 0.05). However, The VAS and ODI scores in Group TR were significantly lower than that in Group T at 6, 12 and 24 months of the post-operation (P < 0.05). The GPE in group TR was high in the early days, while that at 1 and 3 months after treatment was significantly higher than that in group T (P < 0.05). The recurrence rate in Group TR was lower than that in Group T (P = 0.002). There was no significant difference in hospitalization time, complications, VAS and ODI score at the pre-operation between the two groups (P > 0.05).ConclusionThese findings suggest that TFESI combined with RF could effectively improve the pain and function, and had a long-term satisfactory effect for the treatment of LDH.

Highlights

To assess the therapeutic efficacy of transforaminal epidural steroid injection (TFESI) combined with radio frequency (RF) for the treatment of lumbar disc herniation (LDH)
The present study aimed to retrospectively analyze the 2-year follow-up data after TFESI combined with RF for the treatment of LDH in YangLing Demonstration Zone Hospital, and evaluate the effectiveness and safety through clinical assessment tools and patient interviews
Patients Patients undergoing TFESI combined with RF or TFESI operation as LDH were screened in this study (Fig. 1)

Summary

Introduction

To assess the therapeutic efficacy of transforaminal epidural steroid injection (TFESI) combined with radio frequency (RF) for the treatment of lumbar disc herniation (LDH). There are many treatment methods for LDH, including conservative treatment, interventional and surgery therapy. Choosing an invasive therapy that has fewer traumas, maintains the integrity and stability of the spine, and reduces the incidence of postoperative complications has become the focus of LDH treatment. Transforaminal epidural hormone injection (TFESI), as a minimally invasive interventional surgery, is widely used in the treatment of LDH [3]. It has the advantages of less trauma, fewer complications, and faster onset. It relieves symptoms by injecting corticosteroids and local anesthetics around the dural and nerve roots that cause radicular pain. The medium- and long-term treatment efficiency of TFESI is unsatisfactory [3, 4]

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Discussion

Conclusion