Effectiveness of Transforaminal Epidural Steroid Injections in Low Back Pain: A One-Year Experience

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Pain Physician 2002, 5 (3): 266-270

Effectiveness of Transforaminal Epidural Steroid Injections in Low Back

Pain: A One-Year Experience

Original Contribution

K. Rosenberg, MD*, s Grabinsky, MD**, Kooser, RN# and

Mark V. Boswell, MD, PhD##

Anesthesia Pain Service, Department of Anesthesiology, University Hospitals

of Cleveland, Cleveland, Ohio.

 

Transforaminal epidural steroid injections under fluoroscopy are an

alternative treatment for lower back pain with radiculopathy. We followed 82

patients with a stand-ardized telephone questionnaire at 2, 6, and 12 months

after the first injection, in order to assess their effectiveness.

Ninety-two patients with radiculopathic back pain due to spinal stenosis,

herniated discs, spondylolisthesis, and degenerated discs, underwent

transforaminal epidural steroid injections under fluoroscopy. Eighty-two

patients were followed with a standardized telephone questionnaire. The

population was divided into four groups: Group I, previous back surgery

(16%); Group II, discogenic abnormalities: herniations, bulges, or

degeneration, (42%); Group III, spinal stenosis (32%); Group IV, those

without MRI (11%).

Age ranged between 24 to 99 years, mean 64.5. Forty-seven were female, 35

male. Thirteen patients (16%) underwent one procedure, 27 patients (33%)

two, 37 patients (45%) three, and five patients (6%) four, an average 2.4

procedures per patient. The pain scores for all patients improved

significantly at all three time points (2, 6 and 12 months) compared to the

initial mean pain score of 7.3 to mean pain scores of 3.4, 4.5 and 3.9

respectively. After one year, 36 patients did not take any pain medications.

Greater than 50% improvement after one year was seen in 23% of Group I; 59%

in Group II; 35% in Group III and 67% in Group IV.

Transforaminal epidural steroid injections can offer significant pain

reduction up to one year after initiation of treatment in patients with

discogenic pain and possibly in patients with spinal stenosis.