Transforaminal Epidural Steroid Injection for Lumbosacral Radiculopathy: Preganglionic versus Conventional Approach.
- Author:
Joon Woo LEE
1
;
Sung Hyun KIM
;
Ja Young CHOI
;
Jin Sup YEOM
;
Ki Jeong KIM
;
Sang Ki CHUNG
;
Hyun Jib KIM
;
Choonghyo KIM
;
Kyu Sung KWACK
;
Jong Won KWON
;
Sung Gyu MOON
;
Woo Sun JUN
;
Heung Sik KANG
Author Information
- Publication Type:Original Article
- Keywords: Spine, interventional procedure; Spine, therapeutic radiology
- MeSH: Triamcinolone Acetonide/*administration & dosage; Spinal Stenosis/complications; Retrospective Studies; Radiculopathy/*drug therapy/etiology; Patient Satisfaction; Pain Measurement; Middle Aged; Male; Lumbosacral Region; Logistic Models; Intervertebral Disk Displacement/complications; Injections, Epidural/*methods; Humans; Glucocorticoids/*administration & dosage; Fluoroscopy; Female; Bupivacaine/administration & dosage; Anesthetics, Local/administration & dosage; Aged; Adult; Adolescent
- From:Korean Journal of Radiology 2006;7(2):139-144
- CountryRepublic of Korea
- Language:English
- Abstract: OBJECTIVE: The present study was undertaken to evaluate the effectiveness of transforaminal epidural steroid injection (TFESI) with using a preganglionic approach for treating lumbar radiculopathy when the nerve root compression was located at the level of the supra-adjacent intervertebral disc. MATERIALS AND METHODS: The medical records of the patients who received conventional TFESI at our department from June 2003 to May 2004 were retrospectively reviewed. TFESI was performed in a total of 13 cases at the level of the exiting nerve root, in which the nerve root compression was at the level of the supra-adjacent intervertebral disc (the conventional TFESI group). Since June 2004, we have performed TFESI with using a preganglionic approach at the level of the supra-adjacent intervertebral disc (for example, at the neural foramen of L4-5 for the L5 nerve root) if the nerve root compression was at the level of the supra-adjacent intervertebral disc. Using the inclusion criteria described above, 20 of these patients were also consecutively enrolled in our study (the preganglionic TFESI group). The treatment outcome was assessed using a 5-point patient satisfaction scale and by using a VAS (visual assessment scale). A successful outcome required a patient satisfaction scale score of 3 (very good) or 4 (excellent), and a reduction on the VAS score of > 50% two weeks after performing TFESI. Logistic regression analysis was also performed. RESULTS: Of the 13 patients in the conventional TFESI group, nine showed satisfactory improvement two weeks after TFESI (69.2%). However, in the preganglionic TFESI group, 18 of the 20 patients (90%) showed satisfactory improvement. The difference between the two approaches in terms of TFESI effectiveness was of borderline significance (p = 0.056; odds ratio: 10.483). CONCLUSION: We conclude that preganglionic TFESI has the better therapeutic effect on radiculopathy caused by nerve root compression at the level of the supra-adjacent disc than does conventional TFESI, and the diffence between the two treatments had borderline statistical significance.
