Transforaminal epidural steroid injection via a preganglionic approach for the treatment of lumbar radicular pain

To evaluate the effectiveness of transforaminal epidural steroid injection (TFESI) for lumbar radiculopathy with respect to effect of injection levels, gender, and age group.

Hundred-fifty-three consecutive patients who underwent to lumbar TFESI were enrolled. The outcomes were measured by using a visual numeric scale (VNS), NASS and EQ-5D. The relationship between possible outcome predictors and the therapeutic effect were evaluated.

All the patients completed the 2nd year follow-up visits. Significant differences were observed between the pre-procedure and post-procedure VNSs, NASS patients' satisfactions scores and EQ-5D (P < 0.01) except 1st and 2nd year follow-up (P=0.12, P=0.27and P=0.19 respectively). Gender (higher in female patients) showed significant effect to pre-procedure VNS (P=0.04). An increase in the level number was significantly associated with an increase in the 6th month (P=0.005, P=0.004 respectively) and the 1st year (P=0.05, P=0.029 respectively) NASS and EQ-5D. No complication was occurred except discitis in two chronic renal failure patients.

Especially in the patients with severe co-morbidities TFESI is an option to provide higher life quality. The clinical course of the success of the TFESI decreases in one year and becomes stable thereafter. In the patients with immune deficiency, the practitioners should always be aware for an infectious complication.