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Contrast spreading patterns in retrodiscal transforaminal epidural steroid injection
Chul Kim1, Hee Eun Choi, Seonghoon Kang
1Department of Physical Medicine and Rehabilitation, Sanggye Paik Hospital, Seoul 139-707, Korea.
Annals of Rehabilitation Medicine
|September 15, 2012
Summary
Retrodiscal (RD) lumbar transforaminal epidural steroid injections show contrast primarily spreads to the cephalic nerve root. Distal spread correlates with reduced pain reduction in L5 radiculopathy patients.
Area of Science:
- Pain Management
- Neurology
- Radiology
Background:
- Lumbar radiculopathy is a common cause of low back pain.
- Transforaminal epidural steroid injections (TF-EPB) are frequently used for pain relief.
- The retrodiscal (RD) approach is one method for administering TF-EPB.
Purpose of the Study:
- To analyze contrast spread patterns using the RD approach in lumbar TF-EPB.
- To determine the relationship between contrast spread patterns and pain reduction in patients with L5 radiculopathy.
Main Methods:
- Patients with L5 radiculopathy received lumbar TF-EPB via the RD approach.
- Contrast dye spread was observed in the L4-5 RD and L5-S1 RD groups.
- Pain intensity was assessed using the visual analogue scale (VAS) before and after the procedure.
Main Results:
- Contrast predominantly spread to the cephalic nerve root in both L4-5 and L5-S1 RD groups.
- Approximately 60% of contrast spread to the proximal nerve root.
- Contrast spread patterns included proximal root, distal root, anterior epidural space, and undefined.
Conclusions:
- The RD approach for lumbar TF-EPB primarily directs contrast to the cephalic nerve root.
- Contrast spread to the distal nerve root was associated with less effective pain reduction.
