Factors associated with the outcome of transforaminal epidural steroid injections

Abstract

Background: This study was undertaken to assaythe effectiveness of transforaminal epidural steroid injections (TFESIs) for sciatica and to identify potential predictors related to treatment outcome. Methods: TFESIs were performed in 150 patients between August 2006 and March 2007. Seventy-five patients (35 women, 40 men; mean age, 59.1 years), who met the inclusion criteria, were studied. Therapeutic effects were evaluated twoweeks after injection. The following potential outcome predictors analyzed were as follows: one level vs. two level injection, Beck depression inventory score (＜13, 14−19, ＞20), Beck anxiety inventory score (＜7, 8−15, ＞16), cause of radiculopathy (spinal stenosis vs. herniated disk), gender, duration of radiculopathy (＜6 months, 6−12 months, ＞6 months), and Oswestry disability index score (＜30, 31−60, ＞60). The relationships between possible outcome predictors and therapeutic effects were evaluated. Results: Forty-nine of the 75 patients (65.3%) had a satisfactory result two weeks after TFESIs. Of these, twenty-four of the 46 patients (52.2%) were treated by a one level injection and 25 (89.3%) of the 29 patients were treated by a two level injection. This outcome was statistically significant (P ＜ 0.01). None of the other potential outcome predictors showed any statistical difference. Conclusions: TFESI is recommended as an effective method of managing radiculopathy. Two-level injectionsmay result in a better outcome than a one-level injection.