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Comparison of Transforaminal and Parasagittal Epidural Steroid Injections in Patients With Radicular Low Back Pain.

Hashemi SM, Aryani MR, Momenzadeh S, Razavi SS, Mohseni G, Mohajerani SA, Esmilijah AA - Anesth Pain Med (2015)

Bottom Line: Mean NRS score was not significantly different between the PIL group compared to the TF group, at 4 weeks (P = 0.19).Number of patients with improved disability (measured by ODI < 20%) was not significantly different in PIL group (78% of cases) compared to the TF group (76% of cases), at 4 weeks (P = 0.21).There were no adverse effects observed in any of our patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology, Akhtar Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

ABSTRACT

Background: Epidural steroid injection (ESI), including transforaminal (TF) epidural injections and interlaminar (IL) epidural steroid injections are commonly performed procedures for the management of lumbosacral radicular pain. Parasagittal interlaminar (PIL) approach could enable higher ventral epidural spread, with fewer complications than TF.

Objectives: This study aims to compare the effectiveness of PIL and TF ESI in relieving the pain and disability of patients with lumbosacral pain.

Patients and methods: This prospective study enrolled 64 patients, aged between 18 to 75 years, with a diagnosis of low back pain and unilateral lumbosacral radicular pain. The patients were randomized to receive fluoroscopically guided epidural injection, through either the PIL or TF approach. Patients were evaluated for effective pain relief [numerical rating scale (NRS) < 3] by 0 - 10 numeric rating scale (NRS) and functional improvement by the Oswestry Disability Index (ODI).

Results: Effective pain relief [numeric rating scale (NRS) < 3] was observed in 77.3% (95% CI: 67‒90.5%) of patients in PIL group and 74.2% (95% CI: 62.4 - 89.4%) of patients in the TF group (P = 0.34), at 4 weeks. Mean NRS score was not significantly different between the PIL group compared to the TF group, at 4 weeks (P = 0.19). Number of patients with improved disability (measured by ODI < 20%) was not significantly different in PIL group (78% of cases) compared to the TF group (76% of cases), at 4 weeks (P = 0.21). There were no adverse effects observed in any of our patients.

Conclusions: The PIL epidural injection is as effective as TF epidural injection in improving pain and functional status, in patients with chronic lumbosacral low back pain, due to disc degeneration.

No MeSH data available.


Related in: MedlinePlus

Comparison of the Proportion of Patients Improving Disability IndexThe ODI was <2 0%, at 2 weeks between the two groups of parasagittal and transforaminal epidural injection (left figure); Mean ODI score during the follow-up time between the two groups of parasagittal and midline epidural injection (right figure).
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fig20499: Comparison of the Proportion of Patients Improving Disability IndexThe ODI was <2 0%, at 2 weeks between the two groups of parasagittal and transforaminal epidural injection (left figure); Mean ODI score during the follow-up time between the two groups of parasagittal and midline epidural injection (right figure).

Mentions: Number of patients with improved disability (measured by ODI < 20%) was not significantly different in parasagittal group (78% of cases), compared to the TF group (76% of cases), at 4 weeks (P = 0.21) (Figure 2). Besides, mean ODI score was also compared between the two groups. Mean ODI was not significantly different in the PIL compared to TF group, at 4 weeks follow up (P = 0.15) (Figure 2). There was no adverse effect observed in any of our patients.


Comparison of Transforaminal and Parasagittal Epidural Steroid Injections in Patients With Radicular Low Back Pain.

Hashemi SM, Aryani MR, Momenzadeh S, Razavi SS, Mohseni G, Mohajerani SA, Esmilijah AA - Anesth Pain Med (2015)

Comparison of the Proportion of Patients Improving Disability IndexThe ODI was <2 0%, at 2 weeks between the two groups of parasagittal and transforaminal epidural injection (left figure); Mean ODI score during the follow-up time between the two groups of parasagittal and midline epidural injection (right figure).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4644318&req=5

fig20499: Comparison of the Proportion of Patients Improving Disability IndexThe ODI was <2 0%, at 2 weeks between the two groups of parasagittal and transforaminal epidural injection (left figure); Mean ODI score during the follow-up time between the two groups of parasagittal and midline epidural injection (right figure).
Mentions: Number of patients with improved disability (measured by ODI < 20%) was not significantly different in parasagittal group (78% of cases), compared to the TF group (76% of cases), at 4 weeks (P = 0.21) (Figure 2). Besides, mean ODI score was also compared between the two groups. Mean ODI was not significantly different in the PIL compared to TF group, at 4 weeks follow up (P = 0.15) (Figure 2). There was no adverse effect observed in any of our patients.

Bottom Line: Mean NRS score was not significantly different between the PIL group compared to the TF group, at 4 weeks (P = 0.19).Number of patients with improved disability (measured by ODI < 20%) was not significantly different in PIL group (78% of cases) compared to the TF group (76% of cases), at 4 weeks (P = 0.21).There were no adverse effects observed in any of our patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology, Akhtar Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

ABSTRACT

Background: Epidural steroid injection (ESI), including transforaminal (TF) epidural injections and interlaminar (IL) epidural steroid injections are commonly performed procedures for the management of lumbosacral radicular pain. Parasagittal interlaminar (PIL) approach could enable higher ventral epidural spread, with fewer complications than TF.

Objectives: This study aims to compare the effectiveness of PIL and TF ESI in relieving the pain and disability of patients with lumbosacral pain.

Patients and methods: This prospective study enrolled 64 patients, aged between 18 to 75 years, with a diagnosis of low back pain and unilateral lumbosacral radicular pain. The patients were randomized to receive fluoroscopically guided epidural injection, through either the PIL or TF approach. Patients were evaluated for effective pain relief [numerical rating scale (NRS) < 3] by 0 - 10 numeric rating scale (NRS) and functional improvement by the Oswestry Disability Index (ODI).

Results: Effective pain relief [numeric rating scale (NRS) < 3] was observed in 77.3% (95% CI: 67‒90.5%) of patients in PIL group and 74.2% (95% CI: 62.4 - 89.4%) of patients in the TF group (P = 0.34), at 4 weeks. Mean NRS score was not significantly different between the PIL group compared to the TF group, at 4 weeks (P = 0.19). Number of patients with improved disability (measured by ODI < 20%) was not significantly different in PIL group (78% of cases) compared to the TF group (76% of cases), at 4 weeks (P = 0.21). There were no adverse effects observed in any of our patients.

Conclusions: The PIL epidural injection is as effective as TF epidural injection in improving pain and functional status, in patients with chronic lumbosacral low back pain, due to disc degeneration.

No MeSH data available.


Related in: MedlinePlus