Characterization of patients with chronic low back pain treated with transforaminal epidural injection
DOI:
https://doi.org/10.1016/j.rccot.2022.08.001Keywords:
low back pain, spinal injection, steroidsAbstract
Introduction: Through this study, the clinical and demographic characterization of patients with chronic low back pain operated on with transforaminal epidural steroid injection will be carried out in a fourth level hospital.
Materials and methods: A retrospective analytical study of longitudinal temporality was carried out, which included 85 adult patients with chronic low back pain operated on with transfora- minal injection from January 1, 2020 to March 31, 2021.
Results: Fifty-three adults (62.4%) were women and 32 (37.6) were men. On average, the age of these individuals was 54 ± 14 years. In 37 cases (43.5%) it was performed bilaterally, and 42 individuals (49.4%) required this type of injection at three lumbar levels. The mean of related symptoms was 24.37 ± 23.5 months. As triggering etiology, 33 individuals (38.8%) had degene- rative disc disease, 25 (29.4%) due to spondyloarthrosis, 16 (18.8%) due to spondylolisthesis. In relation to subjective low back pain, a decrease of −4.1±3.4 (CV=82.1%) (p=0.00) was recorded.
Discussion: Transforaminal epidural steroid injection in patients with chronic low back pain is a safe and minimally invasive procedure, which during the period of time studied did not present complications or subsequent hospitalization. The majority of the intervened population corresponds to women between 35 and 55 years of age. A decrease in subjective low back pain was observed after one month of performing this procedure.
Level of evidence: Retrospective analytical study of longitudinal temporality. Level III.
Downloads
References
Patrick N, Emanski E, Knaub MA. Acute and chronic low back pain. Med Clin North Am. 2014;98:777-89, https://doi.org/10.1016/j.mcna.2014.03.005
Will JS, Bury DC, Miller JA. Mechanical Low Back Pain. Am Fam Physician. 2018;98:421-8.
Last AR, Hulbert K. Chronic low back pain: evaluation and management. Am Fam Physician. 2009;79:1067-74.
Golob AL, Wipf JE. Low back pain. Med Clin North Am. 2014 May;98:405-28, https://doi.org/10.1016/j.mcna.2014.01.003
Koes BW, van Tulder MW, Thomas S. Diagnosis and treatment of low back pain. BMJ. 2006;332:1430-4, https://doi.org/10.1136/bmj.332.7555.1430
Ghai B, Bansal D, Kay JP, Vadaje KS, Wig J. Transforaminal versus parasagittal interlaminar epidural steroid injection in low back pain with radicular pain: a randomized, double-blind, active- control trial. Pain Physician. 2014;17:277-90. https://doi.org/10.36076/ppj.2014/17/277
Kozlov N, Benzon HT, Malik K. Epidural steroid injections: update on efficacy, safety, and newer medications for injection. Minerva Anestesiol. 2015;81:901-9.
Joswig H, Neff A, Ruppert C, Hildebrandt G, Stienen MN. The Value of Short-Term Pain Relief in Predicting the Long-Term Outcome of Lumbar Transforaminal Epidural Steroid Injections. World Neurosurg. 2017;107:764-71, https://doi.org/10.1016/j.wneu.2017.08.055
Singh JR, Cardozo E, Christolias GC. The Clinical Efficacy for Two-Level Transforaminal Epidural Steroid Injections. PM R. 2017;9:377-82, https://doi.org/10.1016/j.pmrj.2016.08.030
Joswig H, Neff A, Ruppert C, Hildebrandt G, Stienen MN. The Value of Short-Term Pain Relief in Predicting the One-Month Outcome of Lumbar Transforaminal Epidural Steroid Injections. World Neurosurg. 2016;96:323-33, https://doi.org/10.1016/j.wneu.2016.09.016
Leung SM, Chau WW, Law SW, Fung KY. Clinical value of transforaminal epidural steroid injection in lumbar radiculopathy. Hong Kong Med J. 2015;21:394-400, https://doi.org/10.12809/hkmj144310
Taskaynatan MA, Tezel K, Yavuz F, Tan AK. The effective- ness of transforaminal epidural steroid injection in patients with radicular low back pain due to lumbar disc herniation two years after treatment. J Back Musculoskelet Rehabil. 2015;28:447-51, https://doi.org/10.3233/BMR-140539
Cansever T, Kabatas S, Civelek E, Kircelli A, Yilmaz C, Musluman M, et al. Transforaminal epidural steroid injection via a preganglionic approach for the treatment of lumbar radicular pain. Turk Neurosurg. 2012;22:183-8, https://doi.org/10.5137/1019-5149.JTN.5151-11.3
Sarı S, Aydın ON, Güleser G, Kurt ̇I, Turan A. Effect of transforaminal anterior epidural steroid injection on neuropathic pain, quality of sleep and life. Agri. 2015;27:83-8, https://doi.org/10.5505/agri.2015.91489
Manchikanti L, Cash KA, Pampati V, Falco FJ. Transforaminal epidural injections in chronic lumbar disc herniation: a randomized, double-blind, active-control trial. Pain Physician. 2014;17:E489-501. https://doi.org/10.36076/ppj.2014/17/E489
Alcántara-Bumbiedro S, Flórez-García MT, Echávarri-Pérez C, García-Pérez F. Escala de incapacidad por dolor lumbar de Oswestry. Rehabilitación. 2006;40:150-8. https://doi.org/10.1016/S0048-7120(06)74881-2