Olguner S K, Celiktas M, Oktay K, Arslan A, Bilgin E, Gezercan Y, Okten A I, Gulsen M
Department of Neurosurgery, Adana City Training Research Hospital, Adana, Turkey.
Department of Spine Surgery, Ortopedia Hospital, Adana, Turkey.
Niger J Clin Pract. 2020 Jun;23(6):835-841. doi: 10.4103/njcp.njcp_24_19.
This study aims to investigate the effectiveness of transforaminal epidural steroid injection (TFESI) in patients with lumbar radicular pain or radiculopathy caused by different spinal pathologies.
One hundred and seventy seven patients who underwent single transforaminal epidural steroid injection were included in the study group and divided into 3 subgroups (central spinal stenosis + lateral recess stenosis, foraminal stenosis, lumbar disc herniation) according to existing spinal pathology. Patients' visuel analogue scale (VAS) measures and Oswestry Disability Index (ODI) scores were recorded and the patients who give favourable response to treatment were called respondents and who were not called as non-respondents. Subgroups were compared statistically at the end of 12 months.
Sixty patients (33.9%) were considered as respondents and 117 patients (66.1%) were non-respondents in the entire study group. Patients with foraminal stenosis included the vast majority of the respondents and showed better results of pain relief as opposed to patients of other groups at the end of 12 months (P < 0.001).
TFESI was an effective treatment modality for pain relief and functional improvement in patients with foraminal stenosis. However, it could not produce the same results in patients with central spinal stenosis and lumbar disc herniations.
本研究旨在调查经椎间孔硬膜外类固醇注射(TFESI)对不同脊柱病变引起的腰椎神经根性疼痛或神经根病患者的有效性。
177例行单次经椎间孔硬膜外类固醇注射的患者纳入研究组,并根据现有的脊柱病变分为3个亚组(中央椎管狭窄+侧隐窝狭窄、椎间孔狭窄、腰椎间盘突出症)。记录患者的视觉模拟量表(VAS)测量值和Oswestry功能障碍指数(ODI)评分,对治疗有良好反应的患者称为反应者,无良好反应的患者称为无反应者。12个月末对亚组进行统计学比较。
整个研究组中,60例患者(33.9%)被视为反应者,117例患者(66.1%)为无反应者。椎间孔狭窄患者中反应者占绝大多数,与其他组患者相比,12个月末疼痛缓解效果更好(P<0.001)。
TFESI是椎间孔狭窄患者缓解疼痛和改善功能的有效治疗方式。然而,对于中央椎管狭窄和腰椎间盘突出症患者,它不能产生相同的效果。