Outcomes of interlaminar and transforminal spinal injections

Area of Science:

• Pain Management
• Neurosurgery
• Radiology

Background:

• Epidural spinal injections are utilized for pain management.
• Two common routes are translaminar and transforaminal.

Purpose of the Study:

• To compare the efficacy and safety of translaminar and transforaminal epidural spinal injections.
• To inform clinical decision-making regarding epidural injection techniques.

Main Methods:

• Review of clinical scenarios dictating the choice between translaminar and transforaminal approaches.
• Analysis of reported outcomes and complication rates for both methods in lumbar and cervical spine.

Main Results:

• Both translaminar epidural steroid injections (TLESI) and transforaminal epidural steroid injections (TFESI) can provide up to 6 months of pain relief in the lumbar spine.
• Cervical translaminar injections may offer longer pain relief and have a lower complication rate compared to cervical transforaminal injections.
• Long-term benefits of lumbar epidural steroid injections are less reliable.

Conclusions:

• The choice between translaminar and transforaminal epidural injections depends on the clinical target (specific nerve root vs. diffuse area).
• Proper technique is crucial for minimizing rare but severe complications associated with epidural injections.
• Cervical translaminar injections may be preferable due to potentially longer relief and lower complication rates.