Transforaminal Epidural Steroid Injection Versus Oral Corticosteroids for Acute Lumbar Radiculopathy: A Prospective...

Area of Science:

• Pain Management
• Neurosurgery
• Musculoskeletal Disorders

Background:

• Acute low back pain with radicular symptoms is a common, disabling condition.
• Corticosteroids are often used when conservative management fails.
• Comparative effectiveness of transforaminal epidural steroid injection (TFESI) vs. oral corticosteroids is not well-defined.

Purpose of the Study:

• Compare short-term pain reduction (VAS), functional improvement (MODI), and neural tension (SLRT) at 12 weeks.
• Evaluate TFESI versus oral corticosteroid therapy for acute lumbar radiculopathy.
• Assess outcomes in patients with MRI-confirmed lumbar radiculopathy.

Main Methods:

• Prospective observational comparative study (June 2023 - Dec 2024) at a tertiary care center.
• 34 patients (18-70 years) with MRI-confirmed lumbar disc herniation and radicular pain received either TFESI (n=17) or oral prednisolone (n=17).
• Outcomes assessed using VAS, MODI, and SLRT at baseline and 1, 3, 6, and 12 weeks.

Main Results:

• TFESI group showed significantly greater improvement in VAS back/leg pain, MODI, and SLRT at 1, 3, and 6 weeks (p < 0.001).
• TFESI led to early median reductions of 70% in leg pain and 60% in back pain.
• By 12 weeks, between-group differences diminished, with statistically comparable outcomes.

Conclusions:

• TFESI provides faster and more pronounced short-term pain relief and functional improvement than oral corticosteroids for acute lumbar radiculopathy.
• Outcomes for TFESI and oral corticosteroids converge by 12 weeks.
• TFESI is an effective option for rapid symptom management in acute lumbar radiculopathy.