Open AccessClinical Effectiveness of Single Lumbar Transforaminal Epidural Steroid Injections
Author(s) -
Kaufmann Timothy J.,
Geske Jennifer R.,
Murthy Naveen S.,
Thielen Kent R.,
Morris Jonathan M.,
Wald John T.,
Diehn Felix E.,
Amrami Kimberly K.,
Carter Rickey E.,
Shelerud Randy A.,
Gay Ralph E.,
Maus Timothy P.
Publication year - 2013
Publication title -
pain medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.893
H-Index - 97
eISSN - 1526-4637
pISSN - 1526-2375
DOI - 10.1111/pme.12122
Subject(s) - medicine , radicular pain , lumbar , epidural steroid injection , confidence interval , odds ratio , retrospective cohort study , low back pain , observational study , anesthesia , single center , back pain , surgery , alternative medicine , pathology
Objectives. To assess the clinical effectiveness of single lumbar transforaminal epidural steroid injections ( TFESI s) in subjects with radicular pain with or without radiculopathy. Design. Retrospective observational series. Setting. Single academic radiology pain management practice. Subjects. Two thousand twenty‐four subjects undergoing single lumbar TFESI s at the L 4‐5, L 5‐ S 1, or S 1 neural foramina. Methods / Outcome Measures. Subjects were assessed with a pain numerical rating scale ( NRS , 0–10) and Roland–Morris disability questionnaire ( R–M , 23‐point D eyo modification) prior to TFESI and at 2 weeks and 2 months follow‐up. Successful pain relief (responders) was defined as either ≥50% reduction in NRS or pain 0/10; functional success was defined as ≥40% reduction in R–M score. Results. There were statistically significant ( P < 0.0001) reductions in mean NRS and R–M scores at 2 weeks and 2 months postinjection. For NRS , 40.9% were responders at 2 weeks and 45.6% at 2 months. For R–M , 31.9% were responders at 2 weeks and 41.3% at 2 months. The proportion of responders for NRS and R–M was higher when there was <3 months of pain (odds ratio 2‐month NRS = 2.42 [95% confidence interval: 1.82, 3.24], odds ratio 2‐month R–M = 2.61 [1.96, 3.48]). For subjects with <3 months of pain, the proportion of responders was 62.4% (56.5, 68.3%) for NRS and 59.3% (53.3, 65.3%) for R–M scores. Conclusions. This retrospective observational study suggests TFESIs are clinically effective in the treatment of lumbar radicular pain. Subjects with a shorter duration of pain are more likely to achieve a successful outcome.