EFFICACY OF TRANSFORAMINAL EPIDURAL STEROID INJECTION IN LUMBOSACRAL RADICULOPATHY

• Published in: Journal of evolution of medical and dental sciences Vol. 5; no. 15; pp. 727 - 731
• Main Authors: Majid, Saheel, Yadav, Dinesh K, Vakil, Suhail M, Ali, Zameer, Bhat, Tauseef A, Ali, Ayaz, Rashid, Shafaqat, Dhar, Shabir A
• Format: Journal Article
• Language: English
• Published: Akshantala Enterprises Private Limited 22.02.2016
• Subjects: Backache; Care and treatment; Radiculopathy; Steroids (Drugs)
• ISSN: 2278-4748; 2278-4802
• DOI: 10.14260/jemds/2016/167

BACKGROUND Lumbosacral radiculopathy is a common medical and socioeconomic problem with a lifetime prevalence estimated to be around 40%-60%. In 1930, Evans reported that sciatica could be treated by epidural injection. The use of epidural corticosteroid injection for the treatment of axial and radicular back pain was first reported in 1953. Lumbar Transforminal Epidural Steroid Injections (TFESIs) are performed to provide symptomatic relief in patients with radicular pain. A transforaminal epidural steroid injection (TFESI) using a small volume of local anaesthetic will anaesthetize the spinal nerve and also partially anaesthetize the dura, the posterior longitudinal ligament, the intervertebral disc and facet joint. For these reasons, fluoroscopy-guided TFESI has become the preferred approach to epidural space. AIMS AND OBJECTIVES To study the role of transforaminal epidural steroid injection in management of radiculopathy. SETTINGS AND DESIGN This prospective study was conducted in the Department of Orthopaedics, SKIMS Medical College and Hospital, Bemina, Srinagar, J and K, India, for a 2-year period from November 2012 to October 2014; 110 cases, both male and female in the age group of 20-60 years having back pain with radiculopathy of varied types and duration without neurodeficit were enrolled in the study. MATERIALS AND METHODS After selecting a patient for giving transforaminal block, we used a local anaesthetic (2% Xylocaine). Contrast media, e.g. Iohexol was used to demarcate the correct positioning of the needle. A spinal needle (20-25 gauge) and 5mL syringe were used to deliver the drug. CONCLUSION Transforaminal epidural steroid injections with long acting anaesthetic is an excellent form of conservative treatment in management of low back ache with radicular pain. It is relatively safe, simple, economical and shortens the time of recovery from severe pain, avoids risks and complications of surgery and also avoids long periods of bed rest. KEYWORDS NSAID-Non-Steroidal Anti-Inflammatory Drugs, TFESI-Transforaminal Epidural Steroid Injection, SLRT-Straight Leg Raising Test, VAS-Visual Analogue Score, SNRB-Selective Nerve Root Block.