4.5 Article

Comparison Between a Single Subpedicular Transforaminal Epidural Steroid Injection and Lateral Recess Steroid Injection in Reducing Paracentral Disc Herniation-Related Chronic Neuropathic Leg Pain: A Retrospective Study

Journal

WORLD NEUROSURGERY
Volume 149, Issue -, Pages E392-E399

Publisher

ELSEVIER SCIENCE INC
DOI: 10.1016/j.wneu.2021.02.011

Keywords

Intervertebral disc degeneration; Lateral recess; Low back pain; Lumbosacral region; Radiculopathy; Subpedicular transforaminal epidural steroid injection

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This retrospective study compared subpedicular TFESI and lateral recess epidural steroid injection techniques in relieving chronic lumbar radicular pain. The results showed that LRSI was more effective than SP-TFESI in treating unilateral lumbar radicular pain due to paracentral disc, with a greater number of patients achieving minimal clinically important difference at the end of 24 weeks.
BACKGROUND: This retrospective study compares the results of 2 different techniques of transforaminal epidural steroid injection (TFESI)-subpedicular (SP-TFESI) and lateral recess epidural steroid injection (LRSI) in relieving chronic lumbar radicular pain. METHODS: Records of 97 patients who had undergone injection for unilateral lumbar radicular pain and had a paracentral disc were analyzed. Numerical rating scale (NRS) and Oswestry Disability Index (ODI) scores were measured at baseline and at 2, 4, 12, and 24 weeks thereafter. RESULTS: At 24 weeks, the NRS was significantly lower than the baseline in both groups; NRS in the LRSI group was significantly lower than NRS in the SP-TFESI group at 12 and 24 weeks (P = 0.02 each). ODI score was also significantly lower in the LRSI group through the 12-week time point (P = 0.003 at 2 weeks; P = 0.009 at 4 weeks; P = 0.02 at 12 weeks). At the end of 24 weeks, a significantly greater number of patients in the LRSI group achieved minimal clinically important difference for NRS and ODI (P = 0.008 and 0.016, respectively). CONCLUSIONS: At the end of 24 weeks, LRSI appears to be a superior technique in relieving unilateral lumbar radicular pain due to a paracentral disc.

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