Duygu Tecer1, Emre Adiguzel2, Arif Kenan Tan2, Mehmet Ali Taskaynatan2. 1. Division of Rheumatology, Department of Physical Medicine and Rehabilitation, Gazi University, Ankara, Turkey. 2. Department of Physical Medicine and Rehabilitation, Turkish Armed Forces Rehabilitation Center, Gülhane Military Medical Academy, Ankara, Turkey.
Abstract
Objective: To explore the outcome differences of lumbar transforaminal epidural steroid injection (TFESI) according to magnetic resonance imaging (MRI) findings in patients with lumbar radicular pain. Design: Retrospective study. Setting: Single university-based interventional pain management unit. Patients: Fifty-nine patients who had lumbar radicular pain with a recent lumbar MRI and three-month follow-up were included. Methods: MRI findings were reviewed for the following items: herniation type (bulging, protrusion, extrusion), herniation location (central, subarticular, foraminal, extraforaminal), high intensity zone (HIZ), and nerve root impingement (NRI). Pain severity was evaluated using a visual analogue scale (VAS) at time of before injection, then two weeks and three months after. Results: Pain scores improved significantly in each group ( P < 0.05) at all time points, but there were no statistically significant differences in improvements according to type or location of disc herniation. Pain scores were significantly lower in patients with HIZ at the second week and in patients with NRI at the third month ( P < 0.05). Conclusions: TFESI was an effective treatment method in patients with radicular pain, irrespective of the type or location of disc herniation. However, greater improvement in pain may be expected at the second week in patients with HIZ and at the third month in patients with NRI.
Objective: To explore the outcome differences of lumbar transforaminal epidural steroid injection (TFESI) according to magnetic resonance imaging (MRI) findings in patients with lumbar radicular pain. Design: Retrospective study. Setting: Single university-based interventional pain management unit. Patients: Fifty-nine patients who had lumbar radicular pain with a recent lumbar MRI and three-month follow-up were included. Methods: MRI findings were reviewed for the following items: herniation type (bulging, protrusion, extrusion), herniation location (central, subarticular, foraminal, extraforaminal), high intensity zone (HIZ), and nerve root impingement (NRI). Pain severity was evaluated using a visual analogue scale (VAS) at time of before injection, then two weeks and three months after. Results:Pain scores improved significantly in each group ( P < 0.05) at all time points, but there were no statistically significant differences in improvements according to type or location of disc herniation. Pain scores were significantly lower in patients with HIZ at the second week and in patients with NRI at the third month ( P < 0.05). Conclusions: TFESI was an effective treatment method in patients with radicular pain, irrespective of the type or location of disc herniation. However, greater improvement in pain may be expected at the second week in patients with HIZ and at the third month in patients with NRI.
Authors: Rene Balza; Sarah F Mercaldo; Connie Y Chang; Ambrose J Huang; Jad S Husseini; Arvin B Kheterpal; F Joseph Simeone; William E Palmer Journal: Skeletal Radiol Date: 2021-05-27 Impact factor: 2.199