Efficacy of Translaminar Epidural Steroid Injection versus Combined Translaminar Epidural Steroid Injection with Selective Nerve Root Injection in Spinal Stenosis

ABSTRACT

OBJECTIVE: To compare treatment effects of translaminar epidural steroid injections (TLESIs) only and selective nerve root injections (SNRIs) with TLESIs in lumbosacral spinal stenosis. METHOD: Thirty-four patients diagnosed with magnetic resonance imaging (MRI), somatosensory evoked potential (SEP) and electromyography (EMG) were included. 16 patients who had somatosensory pathway dysfunction or abnormal spontaneous activity received combined SNRIs with TLESIs and 20 patients received only TLESIs. The visual analogue scale (VAS) and functional rating index (FRI) were measured before injection, 1 week and 3 months after 3 times injection. RESULTS: The mean values of VAS before injection, 1 week and 3 months after 3 times injection were 7.55, 3.22, 3.61 in only TLESIs and 7.37, 2.06, 2.31 in SNRIs with TLESIs. The mean values of FRI before injection, 1 week and 3 months after 3 times injection were 25.16, 16.00, 15.83 in only TLESIs and 22.50, 8.37, 8.31 in SNRIs with TLESIs. In the mean values of VAS and FRI were significantly lower SNRIs with TLESIs than only TLESIs (p<0.05). CONCLUSION: Combined SNRIs with TLESIs were more effective treatment for reduction of pain and improvement of function than only TLESIs in lumbosacral spinal stenosis.