Epidural Transforaminal Infraneural Infiltration Using Corticosteroids in Lumbar Radiculopathy

A lumbar disc herniation is the primary cause of sciatica, affecting 1% to 5% of the population annually. Epidural corticosteroid injections, whether via the transforaminal or interlaminar route, are an option for patients with refractory sciatica pain. The transforaminal route has the advantage of directly addressing the site of pathology in the anterior epidural space, between the disc herniation and the nerve root.

To evaluate the efficacy of transforaminal infraneural epidural injections using corticosteroids in the treatment of radiculopathy secondary to acute lumbar disc herniation.

Descriptive, nonrandomized, retrospective, and uncontrolled single-center study.

Patients with radiculopathy secondary to acute lumbar disc herniation who underwent transforaminal epidural infiltrations between 2022 and 2024 were included.

Efficacy of transforaminal infraneural epidural injections using corticosteroids in the treatment of radiculopathy secondary to acute lumbar disc herniation.

The inclusion criteria were (1) patients with onset of radiculopathy symptoms in the lower limbs less than 12 weeks prior; (2) patients with persistent radiculopathy symptoms in the lower limbs for more than 8 weeks; (3) clinical signs and symptoms of radiculopathy; (4) lumbar spine magnetic resonance imaging showing discopathy compatible with the clinical examination; and (5) minimum age of 18 years. From a technical standpoint, the entire procedure was performed in the operating room with sedation and local anesthesia.

Radicular blocks are minimally invasive forms of treatment for radiculopathy refractory to medication-based analgesia due to an acute lumbar disc herniation. Transforaminal blocks offer the advantage of providing analgesia with a smaller amount of corticosteroid and represent a nonsurgical alternative that appears to be effective in treating radiculopathy secondary to acute lumbar disc herniation.

This study highlights that infraneural transforaminal epidural steroid injection provides effective analgesia for acute lumbar radiculopathy secondary to disc herniation while using a smaller corticosteroid dose. This approach may help reduce systemic exposure and procedural risks, offering a safer alternative for patients requiring minimally invasive pain management.