The efficacy of transforaminal epidural steroid injections in lumbosacral radiculopathy.
Neurol India
; 59(5): 685-9, 2011.
Article
in En
| MEDLINE
| ID: mdl-22019651
ABSTRACT
BACKGROUND:
Transformational epidural steroid (TFES) is commonly used to treat lumbosacral radicular pain. However, very few studies have systematically evaluated the quality of analgesia following such procedures with respect to time.OBJECTIVE:
To evaluate long-term efficacy of TFES in patients with lumbosacral radiculopathy. MATERIALS ANDMETHODS:
A prospective study including 30 patients having lumbosacral radiculopathy secondary to prolapsed disc. Outcome variables were the amount of improvement just after the procedure and thereafter at 24 hrs, 1 month, 6 month and 1 year post-procedure, respectively, using visual analog scale (VAS) and numeric rating scale (NRS). Patients also filled Roland-Morris questionnaire pre-procedure, 6 month and 1 year follow-up. All patients received Ibuprofen for 3 days following the procedure, to alleviate post- procedural pain. An option of rescue surgery was reserved in case of unbearable pain (>7 VAS), appearance of sudden motor deficit or if patient opts for surgery. Same injection was repeated if at any point of time pain had >5 in VAS.RESULTS:
As per NRS, almost all patients had complete pain relief (mean 98%) immediate postprocedure. At 24 hrs, the score was 79%, at 1 month 60%, at 6 months 58.5% and at 1 year 59%. Preprocedure VAS was 9.2 and thereafter 0.6, 1.8, 3.9, 3.8 and 4.2 at similar time points. Roland-Morris score was 18/24, 10/24, 9/24, at pre-procedure, at 6 months and at 1 year, respectively. No complication was noted in any patient except post procedural local pain.CONCLUSION:
Quality of pain relief produced by TFES was significant. Long-term quality of pain relief was better in patients with pain duration less than 6 months. Even though, the study was designed to inject the drug once, many of the patients required second injection. A further study with multiple injections at prefixed time interval might probably result in a better overall outcome.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Radiculopathy
/
Injections, Epidural
/
Methylprednisolone
/
Anti-Inflammatory Agents
Type of study:
Observational_studies
Limits:
Adult
/
Female
/
Humans
/
Male
Language:
En
Journal:
Neurol India
Year:
2011
Document type:
Article
Affiliation country:
India