Predictive Factors of Efficacy of Transforamenal Epidural Steroid Injection for Patients with Lumbar Discogenic Radiculopathy in Neurosurgery Department

• Main Authors: Hassan Al-Shatoury, Ali Khedr, Ali Abou- Madawi, Medhat Marzouk
• Format: Article
• Language: English
• Published: Egyptian spine association 2013-04-01
• Series: Egyptian Spine Journal
• Subjects: Lumbar Disc Prolapse; sciatica; Low back pain; Steroids; Transforaminal injection
• Online Access: http://esj.journals.ekb.eg/article_3813.html

Background Data: Transforaminal Epidural Steroid Injection is one of the nonsurgical treatment methods for sciatic pain. The clinical outcome and predictive factors that affect its results are still under debate. Purpose: The purpose of this study is to evaluate the results of transforaminal epidural steroid injection and identify factors for predicting success. Study Design: A descriptive analytic cross sectional prospective study involving 45 patients with lumbar radiculopathy. Patients and Methods: Forty-Five patients with lumbar radiculopathy were prospectively followed up at 2 weeks and 6 months after Transforaminal Epidural Steroid Injection. The intensity of radicular pain was scored on the Visual Analog Scale (VAS). Outcome was classified as “respondent” when the pain diminished by 50% or more, “Non-respondent” for a diminution of less than 50%. Duration of symptoms, affected level, position of disc herniation, degree of nerve root compression, pain intensity, and body mass index were chosen as predictive factors to study. Results: The mean VAS scores were 7.381.11± before, 2.93 (SD 2.01) 2 weeks after the procedure, and 4.182.75± at 6 months follow-up. Outcome was graded as respondent in 31 patients (68.9%), and non-respondent in 14 patients (31.1%). Level and position of disc herniation, body mass index, and pain intensity were not predictive factors of radicular pain relief, whereas the symptom duration before the procedure and degree of nerve root compression were highly correlated with the pain relief outcome. Minor complications occurred in 2 patients. Conclusion: Transforaminal Epidural Steroid Injection is a simple, safe, and effective nonsurgical procedure. Patients with shorter duration of symptoms, and minimal degree of nerve root compressions shows better improvement. (2013ESJ036)