Effect Of Transforaminal Anterior Epidural Steroid Injection On Neuropathic Pain, Quality Of Sleep And Life

Abstract

Özet Amaç: Bu çalışmada bel ağrısı dolayısı ile transforaminal anterior epidural steroid injeksiyonu (TAESİ SummaryObjectives: Transforaminal anterior steroid injections are frequently used for low back pain. In the current study, It was aimed to investigate the effects of transforaminal anterior epidural steroid injection (TAESI) in patients with low back pain in regards to quality of life and sleep, and neuropathic pain. Methods: Ethics committee approval and patient consent were obtained. Patients with low back pain scheduled to receive transforaminal epidural steroid injections between October 2011 and October 2012 were included into the study. Pittsburgh Sleep Quality Index (PSQI), Short form 12 (SF 12), DN4 tests and Visual Analog Scale Score (VAS) were measured prior to procedure and three months later. All the tests were compared with baseline evaluations prior to injections. Results: One hundred and two (female/male: 52/50) patients with a mean age of 53.3±1.4 were included. Primary diagnoses were lumbar disc herniation in eighty-seven patients, spinal stenosis in seven and failed back surgery syndrome in eight patients. Statistically significant improvement was seen in the total VAS, DN4 and PSQI scores (p=0.0001) of the patients at the third month follow-up. Sleep duration (p=0.0001), habitual sleep efficiency (p=0.0001), subjective sleep quality (p=0.003), sleep latency (p=0.014), sleep disturbances (p<0.001), sleep medication use (p=0.003), and day time dysfunction (p=0.015) showed a significant decrease in sub-components. There was no significant difference in SF 12 quality of life. Conclusion: It was determined in the study that transforaminal epidural steroid injection provided a substantial improvement in patients' pain and neuropathic pain and quality of sleep, but had no effect on the quality of life.

Effect of lumbar epidural steroid injection on neuropathic pain: a prospective observational study

“…Our findings are consistent with those from a previous studies [5] , [6] , in which ESI (80 mg of triamcinolone plus 3 mL of 0.5% bupivacaine; 3 months follow up) provided a substantial improvement in patient pain levels, neuropathic pain levels, and quality of sleep, but had no effect on quality of life [5] .…”

“…An epidural steroid injection (ESI) is often used to treat neuropathic pain (NP) [5] , [6] . The pain mechanism of nociceptive pain and neuropathic pain are different.…”

“…Steroids including 80 mg methylprednisolone are efficient at alleviating a patient's overall pain, and both interlaminar (IL) and transforaminal (TF) epidural steroid injection (ESI) can reduce the neuropathic component in patients with chronic lumbar radicular pain [6] . In addition, an 80 mg triamcinolone TFESI has been reported to provide a substantial improvement in patients' pain and neuropathic pain and quality of sleep, but had no effect on patient the quality of life [5] .…”

Comparison of treatment outcomes in lumbar central stenosis patients treated with epidural steroid injections: interlaminarversusbilateral transforaminal approach

“…The DN4 is widely used in the studies published in the literature, which were focused on the evaluation of several treatment methods performed for chronic low back pain associated with NP [ 19 , 20 ]. It is a suitable tool with a very good sensitivity (83%) and specificity (90%) to evaluate the presence of NP in chronic back pain [ 21 ].…”

A Case Of Herpes Zoster Following An Epidural Steroid Injection

“…Hastaların sosyal yaşamında ciddi kısıtlamalara yol açan bel ağrısının en sık nedenlerinden birisi lumbar spinal stenozdur ve en sık nedeni yaşlanmaya bağlı dejenerasyondur (1) . Tedavide öncelikle yatak istirahati, ilaç tedavisi ve fizik tedavi gibi konservatif yaklaşımlar denenmelidir.…”