Transforaminal Epidural Steroid Injection in Lumbar Radicular Pain

Abstract

Objective: To evaluate the efficacy of transforaminal epidural steroid injection (TFESI) in patients with lumbar radicular pain and emphasis on the 1 year outcome of this minimally invasive pain management procedure. Patients and Methods: 84 patients with lumbar radicular pain due to inter vertebral disc degeneration (IVDD) and facetal hypertrophy causing neural foraminal narrowing without motor deficit or bladder/bowel disturbance were treated with TFESI between May 2014 to August 2018 in a Tertiary care medical center in India. Patient’s pain status was assessed at 1 month, 6 months and 1 year of discharge. 59 out of 84 patients (70%) with follow-up data were included in the study and patients with motor or bladder/bowel deficit were excluded from the study. Results: 58 out of 59 patients had significant pain relief at the time of discharge after a day of the procedure. 1 patient had persistent pain and was managed surgically. 2 patients developed pain & EHL weakness at 3rd month and 6th month follow up respectively and were managed surgically. 5 patients had recurrence of pain with no any neurological deficit. They were taken up for repeat TFESI after repeat MRI spine scan and all improved symptomatically. To summarize, 56 (94.91%) patients were benefited by TFESI at the end of 1 year of follow-up and 3 (5.09%) patients were benefited by surgical intervention after failed TFESI. No peri procedural complication is encountered. Conclusion: TFESI is an effective minimally invasive procedure in patients with lumbar radicular pain with a good 1 year post procedural pain relief.