Can Epidural Contrast Dispersal Pattern Help To Predict the Outcome of Transforaminal Epidural Steroid Injections in Patients with Lumbar Radicular Pain.

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Can Epidural Contrast Dispersal Pattern Help To Predict the Outcome of Transforaminal Epidural Steroid Injections in Patients with Lumbar Radicular Pain.

World Neurosurg. 2018 May 08;:

Authors: Duygu Tecer MD, Adiguzel E, Koroglu O, Tan AK, Taskaynatan MA

Abstract
BACKGROUND: To investigate the relationship between epidurographic contrast dispersal patterns and both immediate and short term clinical effectiveness of lumbar transforaminal epidural steroid injections (TFESIs) in patients with radicular back pain.
METHODS: Digital database of 64 patients who underwent single-level lumbar TFESI for unilateral lumbar radicular pain were scanned Type of contrast pattern was analyzed by 1 physiatrist and definied as follows: type I (tubular appearance); type II (nerve root visible as a filling defect); or type III (cloudlike appearance). Pain was evaluated with Visual analogue scale (VAS) and recorded before injection and 2 days, 2 weeks and 3 months after injection.
RESULTS: The mean age was 45.9 ± 13.5 years (range: 22-80 years) and the mean duration of the symptoms was 5.7 ± 4.2 months. Contrast distribution pattern was as follows: type I in 33 patients (51.6%), type II in 18 patients (28.1%), type III in 13 patients (20.3%). Mean decrease in VAS scores at all time points was statistically significant in three types of contrast dispersal patterns (p<0.05). Differences in improvements of VAS scores obtained at any assessment period and success rates were not statistically significant between the groups. But ratio of patients who achieved 50% or greater reduction in pain score were higher in in type 1 and type 2 than type 3 at each follow- up points.
CONCLUSION: TFSEIs have a beneficial effect in managing lumbar radicular pain regardless of contrast pattern type. Success rate were higher in type 1 and type 2 than type 3.

PMID: 29751191 [PubMed - as supplied by publisher]

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