Transforaminal Epidural Steroid Injection in Lumbar Disc Prolapse: Impact on Pain Intensity and Cognitive Function in...

Area of Science:

• Neuroscience
• Biochemistry
• Orthopedics

Background:

• Lumbar disc prolapse is a prevalent cause of disabling low back pain, with incidence increasing with age.
• Understanding the mechanisms behind pain and functional decline in lumbar disc prolapse is crucial for effective treatment.

Purpose of the Study:

• To evaluate the impact of transforaminal epidural steroid injection (TFESI) on pain intensity, cognitive function, and serum miR-155 levels in patients with lumbar disc prolapse.
• To explore potential epigenetic modifications associated with TFESI treatment.

Main Methods:

• A case-control study involving 44 patients with symptomatic lumbar disc prolapse (L4-L5) and 44 age- and sex-matched controls.
• Pain intensity and functional disability were assessed using Numeric Rating Scale (NRS), Oswestry Disability Index (ODI), and Functional Rating Index (FRI) before and 1 month after TFESI.
• Cognitive function and serum miR-155 levels were measured before and 1 month after TFESI.

Main Results:

• TFESI led to statistically significant improvements in pain scales and cognitive test scores (p ≤ 0.05).
• A significant reduction in serum miR-155 levels was observed 1 month post-TFESI (p < 0.001).
• Pre-treatment miR-155 levels correlated significantly with pain, disability, and cognitive function scores.

Conclusions:

• TFESI offers a significant therapeutic benefit for lumbar disc prolapse by reducing pain and enhancing cognitive function.
• The study suggests that TFESI exerts its effects partly through epigenetic mechanisms, specifically the downregulation of miR-155.
• These findings highlight the role of miR-155 in the pathophysiology of lumbar disc prolapse and its modulation by TFESI.