Effect of Transforaminal Epidural Injection in Patients with Lumbar Radicular Pain

ABSTRACT

OBJECTIVE: To determine the therapeutic effect of transforaminal epidural injections in patients with refractory lumbar radicular pain. METHOD: Thirty-five patients with lumbar radicular pain who did not receive any other interventional procedures were studied. Transforaminal epidurograms and epidural steroid injections via eighty-nine intervertebral foramens were performed under C-arm fluoroscopic visualization. After confirmation of proper needle placement, 20~40 mg of triamcinolone and 1 cc of 2% lidocaine hydrochloride were injected into each safe triangle of the intervertebral foramen. Patients were evaluated for visual analogue scale (VAS) and straight leg raising (SLR) test at pre-injection, 1 week post-injection and 3 months post-injection. Changes over time were assessed statistically using ANOVA. RESULTS: The averages of VAS reduced significantly (p<0.05) from 5.6+/-1.8 at pre-injection, to 3.5+/-1.7 at 1 week pos-tinjection, to 2.1+/-2.0 at 3 months post-injection, respectively. The averages of SLR augmented significantly (p<0.05) from 51.6degrees +/- 16.7degrees at pre-injection, to 66.6degrees +/-16.0degrees at 1 week post-injection, to 77.2degrees +/- 15.1degrees at 3 months post-injection, respectively. Twenty-six out of thirty-five patients (74.3%) had a successful long-term outcome, reporting at least an over 50% reduction between pre-injection and 3 months post-injection in VAS. CONCLUSION: Transforaminal epidural injection is an effective treatment for patients with lumbar radicular pain when evaluated after 1 week and 3 months post-injection.