Clinical Effectiveness of Single Lumbar Transforaminal Epidural Steroid Injections. Issue 8 (22nd April 2013)

• Record Type: Journal Article
• Authors: 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.
• Is Part Of: Pain medicine. Volume 14:Issue 8(2013)
• Page Start: 1126
• Page End: 1133
• Publication Date: 2013-04-22
• Subjects: Pain -- Periodicals; Pain -- Treatment -- Periodicals; Analgesics -- Periodicals; Pain -- Periodicals; Pain Management -- Periodicals; Douleur -- Périodiques; Douleur -- Traitement -- Périodiques; Analgésiques -- Périodiques; Analgésique; Soulagement de la douleur; Périodique électronique (Descripteur de forme); Ressource Internet (Descripteur de forme); 616.047205
• DOI: 10.1111/pme.12122
• Languages: English
• ISSNs: 1526-2375

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="pme12122-sec-0001" sec-type="section"> <title>Objectives.</title> <p>To assess the clinical effectiveness of single lumbar transforaminal epidural steroid injections (TFESIs) in subjects with radicular pain with or without radiculopathy.</p> </sec> <sec id="pme12122-sec-0002" sec-type="section"> <title>Design.</title> <p>Retrospective observational series.</p> </sec> <sec id="pme12122-sec-0003" sec-type="section"> <title>Setting.</title> <p>Single academic radiology pain management practice.</p> </sec> <sec id="pme12122-sec-0004" sec-type="section"> <title>Subjects.</title> <p>Two thousand twenty‐four subjects undergoing single lumbar TFESIs at the L4‐5, L5‐S1, or S1 neural foramina.</p> </sec> <sec id="pme12122-sec-0005" sec-type="section"> <title>Methods / Outcome Measures.</title> <p>Subjects were assessed with a pain numerical rating scale (NRS, 0–10) and Roland–Morris disability questionnaire (R–M, 23‐point Deyo 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.</p> </sec> <sec id="pme12122-sec-0006" sec-type="section"> <title>Results.</title> <p>There were statistically significant (<italic>P</italic> < 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.</p> </sec> <sec id="pme12122-sec-0007" sec-type="section"> <title>Conclusions.</title> <p>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.</p> </sec> </abstract>