Comparison of the effect of single lumbar transforaminal epidural steroid injections for the treatment of l4-5 and l5-s1 paramedian disc herniation

Adilay, Utku; Güçlü, Bülent; Deniz, Levent; Kahveci, Ramazan

doi:10.5137/1019-5149.jtn.24029-18.1

Cited by 6 publications

(3 citation statements)

References 5 publications

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“…In the study by Ghahreman and Bogduk [37], they concluded that the success of transforaminal epidural corticosteroid application was almost three times greater in patients with lesser nerve root compression. According to Adiley et al [38], the comparison ofthe PRT effects in L4-L5 and L5-S1 on disc herniation showed greater efficiency in L4-L5 levels. The results are also compatible with the study by Shrestha et al [39], where the successful treatment at the L5-S1 level was 57.14% compared to the L4-L5 level of 79.17%.…”

Section: Discussionmentioning

confidence: 98%

Clinical Effectiveness of Single Lumbar Periradicular Infiltration in Patients with Sciatica

Veljanovski¹,

Panev²,

Kostova³

et al. 2023

Prilozi

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Periradicular therapy (PRT) is a minimally invasive radiological procedurein patients with chronic lumbar pain.The aim of the study is to identify clinical and radiological predictive factors for treatment success after a single PRT treatment in patients with sciatica.The study includes a prospective follow-up of 166 patients treated with PRT. The pain intensity is determined according to the VAS scale and the degree of improvement is presented as excellent (over 75%), good (50-70%), moderate (25-49%), and weak (less than 25%). The follow up of the treated patients was done at 2 weeks, 3 and 6 months. In patients with pain duration up to 3 months, the improvement was excellent in n=32 (58.18%) after 2 weeks, after 3 months n=41 (74.55%) and after 6 months n=41 (74.55%). This stands in contrast to patients with pain over 1 year. The percentage of improvement after 6 months, post-intervention, was highest in patients without nerve root compression (86.25±19.2),and the highest improvement after 6 months was in patients with localization of pain at the L4-L5 level (69.69±29.7), the greatest improvement after six months was in patients with extraforaminal hernia (62.82±34.3), and the lowest in patients with central stenosis (40.21±30.7).Our study results suggest that the shorter a pain duration, low-grade root compression, injection level and type of herniation area predictor the more favourable response patients have to transforaminal epidural steroid injection in patients with sciatica.

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Section: Discussionmentioning

confidence: 98%

Clinical Effectiveness of Single Lumbar Periradicular Infiltration in Patients with Sciatica

Veljanovski¹,

Panev²,

Kostova³

et al. 2023

Prilozi

View full text Add to dashboard Cite

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“…Donoszono, że jeden na czterech pacjentów poddanych ESI z powodu przepukliny lub zwężenia kręgosłupa lędźwiowego miał następnie operację, a prawie jeden na sześciu miał operację w ciągu pierwszego roku [22]. Badanie wykazało, że transforaminalne zewnątrzoponowe iniekcje glikokortykosteroidowe w przypadku przepukliny dysku paramedian L4-5 były bardziej skuteczne niż transforaminalne zewnątrzoponowe iniekcje glikokortykosteroidowe w przypadku przepukliny dysku L5-S1 w 12-tygodniowym okresie obserwacji [23].…”

Section: Leczenie Farmakologiczneunclassified

Treatment of lumbar intervertebral disc herniation - a review of the latest therapeutic methods

KLOCEK

Bartosz²,

Aleksandra

et al. 2023

J Educ Health Sport

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Introduction and purpose: The aim of this study is to provide a comprehensive description of intervertebral disc herniation, with a focus on the lumbar spine, including the current conservative and modern surgical treatment options such as minimally invasive procedures. State of Knowledge: Spinal pain is a prevalent cause of disability in developed countries, with an increasing number of people affected by this condition. Intervertebral disc herniation resulting from degenerative changes is a common pathology, particularly in the lumbar and cervical spine. This condition involves the protrusion of the nucleus pulposus, which exerts pressure on the spinal roots, causing irritation. While the prognosis for herniated nucleus pulposus is usually positive and many patients can undergo conservative treatment, some may require a surgery. Due to advancements in technology, the current goal is to minimize tissue trauma during hernia repair procedures. Conclusions: Due to advances in treatment of lumbar intervertebral disc herniation, patients can achieve better clinical outcomes and improved quality of life. Conservative treatment should be considered as the first line treatment in a majority of cases. Surgery is usually a last resort when conservative treatment proves insufficient. No surgical method seems to be unequivocally superior to the others, so its choice is tailored to the individual patient's needs and depends on the surgeon's preferences and experience. Recent advances in endoscopic spine surgery are providing new insights into disc surgery and pain management strategies.

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“…The effectiveness of TFESI under fluoroscopy for the alleviation of radicular pain because of the LDH has been demonstrated in different studies (1,2,3,6,9). In individuals with extruded LDH, the mean VASs for radicular pain before and after the procedure were 87.65 ± 5.59 and 22.81 ± 4.01, for each group.…”

mentioning

confidence: 95%

Optimal timing and outcome of transforaminal epidural steroid injection for the management of radicular pain due to extruded lumbar disc herniation

Güçlü¹,

Deniz²,

Katar³

et al. 2023

Turkish Neurosurgery

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AIM:To evaluate the optimal timing and outcome of fluoroscopically guided transforaminal epidural steroid injections (TFESI) for the management of radicular pain due to extruded lumbar disc herniation (LDH). MATERIAL and METHODS:In this clinical study, 305 individuals received fluoroscopically guided TFESI for the management of radicular pain due to extruded LDH. Preprocedural and 12-week postprocedural Visual Analog Scale (VAS) scores measuring radicular pain were statistically compared. The neurological conditions of the patients and the complications of the procedure were also recorded. RESULTS:The intensity of radicular pain evaluated by the mean preprocedural and 12-week postprocedural VASs were 87.65 ± 5.59 and 22.81 ± 4.01, respectively. The P value was p:0.001 (p < 0.05) and t value was 119.01. A correlation was noted between the short duration of symptoms before the procedure and the effectiveness of the procedure. After 12 weeks of the procedure, 32 of the 58 patients showed improvement in a neurological deficit. There was no major complication. Nine patients required lumbar disc surgery after the procedure. CONCLUSION:This clinical research demonstrated that TFESI for the management of extruded LDH may alleviate radicular pain and may decrease the neurological deficit and that it is more effective when performed at the earliest possible time point.

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Comparison of the effect of single lumbar transforaminal epidural steroid injections for the treatment of l4-5 and l5-s1 paramedian disc herniation

Cited by 6 publications

References 5 publications

Clinical Effectiveness of Single Lumbar Periradicular Infiltration in Patients with Sciatica

Clinical Effectiveness of Single Lumbar Periradicular Infiltration in Patients with Sciatica

Treatment of lumbar intervertebral disc herniation - a review of the latest therapeutic methods

Optimal timing and outcome of transforaminal epidural steroid injection for the management of radicular pain due to extruded lumbar disc herniation

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