Percutaneous Adhesiolysis Versus Transforaminal Epidural Steroid Injection for the Treatment of Chronic Radicular Pain Caused by Lumbar Foraminal Spinal Stenosis: A Retrospective Comparative Study

Park, Yongbum; Lee, Woo Yong; Ahn, Jae Ki; Nam, Hee-Seung; Lee, Ki Hoon

doi:10.5535/arm.2015.39.6.941

Cited by 19 publications

(24 citation statements)

References 39 publications

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“…In [28], the degree of the lateral canal stenosis in the MRI did not correlate with the initial TFESI-induced pain relief of the patients with the degenerative lumbar scoliosis stenosis. Likewise, a number of articles discuss the effectiveness of TFESIs in patients with spinal stenosis [29303132]; according to these articles, there is a dearth of evidence regarding the effectiveness of TFESIs for the radicular pain that is caused by the spinal stenosis. In addition, in a previous study, the severity of the spinal stenosis is not significantly different for the patients with the improvement compared with the patients without the improvement [33].…”

Section: Discussionmentioning

confidence: 99%

The Prognostic Value of Enhanced-MRI and Fluoroscopic Factors for Predicting the Effects of Transforaminal Steroid Injections on Lumbosacral Radiating Pain

et al. 2016

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ObjectiveTo investigate the predictive value of enhanced-magnetic resonance imaging (MRI) and fluoroscopic factors regarding the effects of transforaminal epidural steroid injections (TFESIs) in low back pain (LBP) patients with lumbosacral radiating pain.MethodsA total of 51 patients who had LBP with radiating pain were recruited between January 2011 and December 2012. The patient data were classified into the two groups ‘favorable group’ and ‘non-favorable group’ after 2 weeks of follow-up results. The favorable group was defined as those with a 50%, or more, reduction of pain severity according to the visual analogue scale (VAS) for back or leg pain. The clinical and radiological data were collected for univariate and multivariate analyses to determine the predictors of the effectiveness of TFESIs between the two groups.ResultsAccording to the back or the leg favorable-VAS group, the univariate analysis revealed that the corticosteroid approach for the enhanced nerve root, the proportion of the proximal flow, and the contrast dispersion of epidurography are respectively statistically significant relative to the other factors. Lastly, the multiple logistic regression analysis showed a significant association between the corticosteroid approach and the enhanced nerve root in the favorable VAS group.ConclusionAmong the variables, MRI showed that the corticosteroid approach for the enhanced target root is the most important prognostic factor in the predicting of the clinical parameters of the favorable TFESIs group.

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Section: Discussionmentioning

confidence: 99%

The Prognostic Value of Enhanced-MRI and Fluoroscopic Factors for Predicting the Effects of Transforaminal Steroid Injections on Lumbosacral Radiating Pain

et al. 2016

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“…For the management of radicular pain, various conservative treatments have been applied for patients with LFSS. Transforaminal epidural steroid injection (TFESI) is one of the most effective methods for controlling radicular pain after LFSS and has been increasingly used lately (6)(7)(8)(9)(10)(11)(12). Corticosteroids inhibit the synthesis of various pro-inflammatory mediators (13).…”

Section: Tfesi Proceduresmentioning

confidence: 99%

“…Therefore, TFESI can reduce nerve root inflammation induced by mechanical compression at the narrowed foramen. Several previous studies demonstrated the effectiveness of TFESI on reducing radicular pain after LFSS (6)(7)(8)(9)(10)(11)(12). However, little is known about the treatment outcome of TFESI according to the severity of LFSS.…”

Section: Tfesi Proceduresmentioning

confidence: 99%

Outcome of Transforaminal Epidural Steroid Injection According to the Severity of Lumbar Foraminal Spinal Stenosis

Chang

2018

Pain Phys

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Background: Lumbar foraminal spinal stenosis (LFSS) is a common cause of radicular pain in the lower extremities. Transforaminal epidural steroid injection (TFESI) is being used widely for controlling radicular pain induced by LFSS. The efficacy of TFESI has been demonstrated in previous studies. However, no study has evaluated the outcome of TFESI according to the severity of LFSS. Objective: In this study, we evaluated the outcome of TFESI in patients with chronic lumbar radicular pain due to LFSS according to the severity of LFSS by using magnetic resonance imaging (MRI). Study Design: A prospective observational study. Setting: A university hospital. Methods: Sixty patients with chronic lumbar radicular pain due to LFSS were included in this prospective study and received TFESI at our university hospital. Three patients were lost to followup. On the basis of sagittal lumbar MRI findings, we assigned patients with mild to moderate LFSS to group A (n = 31) and those with severe LFSS to group B (n = 26). Pain intensity was evaluated using a numeric rating scale (NRS) before treatment and at 1, 2, and 3 months after treatment. Results: Compared to pretreatment NRS scores, a significant decrease in NRS scores was observed in patients in both groups at 1, 2, and 3 months after treatment (P = 0.000). However, reductions in the NRS scores over time were significantly larger in group A (P = 0.023). Three months after treatment, 27 patients (87.1%) in group A and 11 patients (42.3%) in group B reported successful pain relief (pain relief of ≥ 50%). Limitations: This study had a small number of patients. Conclusions: After TFESI, chronic lumbar radicular pain was significantly reduced regardless of the severity of LFSS, and the effects of TFESI were sustained for at least 3 months after treatment. However, the outcome of TFESI was superior in the group with a mild to moderate degree of LFSS, compared to the group with a severe degree of LFSS. We believe that our study provides useful information for establishing a treatment plan for radicular pain due to LFSS. Key words: Lumbar foraminal spinal stenosis, transforaminal epidural steroid injection, disease severity, magnetic resonance imaging, numeric rating scale, corticosteroids

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“…The short‐term positive effectiveness of TFESI for controlling radicular pain following LSS has been well demonstrated in several previous studies 7,11–14 . However, the long‐term outcome of TFESI on LSS has been rarely studied.…”

Section: Discussionmentioning

confidence: 93%

“…Additionally, it can block the transmission of nociceptive signals through the nerve fibers 10 . The short‐term pain‐reducing effects of lumbar TFESI is well demonstrated 7,11–14 . However, little is known about the long‐term effect of lumbar TFESI for managing lumbar radicular pain due to LSS.…”

Section: Introductionmentioning

confidence: 99%

At Least 5‐Year Follow‐up After Transforaminal Epidural Steroid Injection Due to Lumbar Radicular Pain Caused by Spinal Stenosis

Jang

Lee

2020

Pain Practice

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Objectives Transforaminal epidural steroid injection (TFESI) can be used to control radicular pain following lumber spinal stenosis (LSS). However, limited information is available on the long‐term prognosis of TFESI in patients with LSS. Methods Of the 90 patients who underwent TFESI for controlling LSS‐induced radicular pain at least 5 years previously, 54 patients completed a phone interview. We inquired about their degree of pain during walking or standing, current oral medication used for radicular pain, current TFESI injections, progression to surgery, and unemployment due to pain at least 5 years after the TFESI for LSS‐induced radicular pain. Results Five to seven years after the initial TFESI, the numeric rating scale (NRS) score had decreased from 6.7 to 3.7. Of the included patients, approximately 65% of the patients had an NRS score of ≥3, although roughly 15% of patients reported complete resolution of the initial pain. Approximately half of the included patients were currently receiving repetitive TFESIs every 2 to 6 months or were taking oral pain medications. Further, approximately 25% of the patients had undergone a surgical intervention; however, its outcome was poor. Conclusion The prognosis after TFESI for controlling LSS‐induced radicular pain is thought to be relatively poor. However, considering poor long‐term outcome and complications after surgery, we believe that TFESI is worth considering as a safe modality for controlling radicular pain following LSS.

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Percutaneous Adhesiolysis Versus Transforaminal Epidural Steroid Injection for the Treatment of Chronic Radicular Pain Caused by Lumbar Foraminal Spinal Stenosis: A Retrospective Comparative Study

Cited by 19 publications

References 39 publications

The Prognostic Value of Enhanced-MRI and Fluoroscopic Factors for Predicting the Effects of Transforaminal Steroid Injections on Lumbosacral Radiating Pain

The Prognostic Value of Enhanced-MRI and Fluoroscopic Factors for Predicting the Effects of Transforaminal Steroid Injections on Lumbosacral Radiating Pain

Outcome of Transforaminal Epidural Steroid Injection According to the Severity of Lumbar Foraminal Spinal Stenosis

At Least 5‐Year Follow‐up After Transforaminal Epidural Steroid Injection Due to Lumbar Radicular Pain Caused by Spinal Stenosis

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