The 1-Year Results of Lumbar Transforaminal Epidural Steroid Injection in Patients with Chronic Unilateral Radicular Pain : The Relation to MRI Findings and Clinical Features
(2017) In American Journal of Physical Medicine and Rehabilitation 96(9). p.654-662- Abstract
OBJECTIVE: In patients with chronic radicular pain, we aimed to evaluate subgroup differences in 1-yr response to transforaminal epidural steroid injection. DESIGN: In this longitudinal cohort study of 100 subjects, 170 transforaminal epidural steroid injections were performed for 1 yr. The sample was stratified by type of disc herniation (protrusion n = 57, extrusion n = 27), by location of disc herniation (central/subarticular n = 60, foraminal n = 24), by grade of nerve root compression (low-grade compression n = 61, high-grade subarticular nerve compression n = 14, high-grade foraminal nerve compression n = 25), and by positive Slump test (n = 67). Treatment response was evaluated by visual analogue scale leg pain and self-reported... (More)
OBJECTIVE: In patients with chronic radicular pain, we aimed to evaluate subgroup differences in 1-yr response to transforaminal epidural steroid injection. DESIGN: In this longitudinal cohort study of 100 subjects, 170 transforaminal epidural steroid injections were performed for 1 yr. The sample was stratified by type of disc herniation (protrusion n = 57, extrusion n = 27), by location of disc herniation (central/subarticular n = 60, foraminal n = 24), by grade of nerve root compression (low-grade compression n = 61, high-grade subarticular nerve compression n = 14, high-grade foraminal nerve compression n = 25), and by positive Slump test (n = 67). Treatment response was evaluated by visual analogue scale leg pain and self-reported disability (Oswestry Disability Index). Logistic regression was used to analyze the predictive value of baseline characteristics including the stratified subgroups. RESULTS: High-grade subarticular nerve compression predicted the 1-yr improvement in both visual analogue scale leg pain (P = 0.046) and Oswestry Disability Index (P = 0.027). Low age (P < 0.001), short duration of leg pain (P = 0.015), and central/subarticular disc herniation (P = 0.017) predicted improvement in Oswestry Disability Index. CONCLUSIONS: In patients treated with one or several transforaminal epidural steroid injections due to chronic lumbar radicular pain, clinical findings failed to predict the 1-yr treatment response. Low age, short duration of leg pain, central/subarticular disc herniation, and high-grade subarticular nerve compression predicted a favorable 1-yr response to transforaminal epidural steroid injection.
(Less)
- author
- Ekedahl, Harald LU ; Jönsson, Bo LU ; Annertz, Mårten LU and Frobell, Richard B. LU
- organization
- publishing date
- 2017-03-02
- type
- Contribution to journal
- publication status
- published
- subject
- in
- American Journal of Physical Medicine and Rehabilitation
- volume
- 96
- issue
- 9
- pages
- 654 - 662
- publisher
- Lippincott Williams & Wilkins
- external identifiers
-
- scopus:85014237923
- pmid:28257294
- wos:000407889500014
- ISSN
- 0894-9115
- DOI
- 10.1097/PHM.0000000000000730
- language
- English
- LU publication?
- yes
- id
- fb0067fe-2f15-4a0c-b9a6-510a799d8ae5
- date added to LUP
- 2017-03-17 15:12:07
- date last changed
- 2025-01-07 09:59:28
@article{fb0067fe-2f15-4a0c-b9a6-510a799d8ae5, abstract = {{<p>OBJECTIVE: In patients with chronic radicular pain, we aimed to evaluate subgroup differences in 1-yr response to transforaminal epidural steroid injection. DESIGN: In this longitudinal cohort study of 100 subjects, 170 transforaminal epidural steroid injections were performed for 1 yr. The sample was stratified by type of disc herniation (protrusion n = 57, extrusion n = 27), by location of disc herniation (central/subarticular n = 60, foraminal n = 24), by grade of nerve root compression (low-grade compression n = 61, high-grade subarticular nerve compression n = 14, high-grade foraminal nerve compression n = 25), and by positive Slump test (n = 67). Treatment response was evaluated by visual analogue scale leg pain and self-reported disability (Oswestry Disability Index). Logistic regression was used to analyze the predictive value of baseline characteristics including the stratified subgroups. RESULTS: High-grade subarticular nerve compression predicted the 1-yr improvement in both visual analogue scale leg pain (P = 0.046) and Oswestry Disability Index (P = 0.027). Low age (P < 0.001), short duration of leg pain (P = 0.015), and central/subarticular disc herniation (P = 0.017) predicted improvement in Oswestry Disability Index. CONCLUSIONS: In patients treated with one or several transforaminal epidural steroid injections due to chronic lumbar radicular pain, clinical findings failed to predict the 1-yr treatment response. Low age, short duration of leg pain, central/subarticular disc herniation, and high-grade subarticular nerve compression predicted a favorable 1-yr response to transforaminal epidural steroid injection.</p>}}, author = {{Ekedahl, Harald and Jönsson, Bo and Annertz, Mårten and Frobell, Richard B.}}, issn = {{0894-9115}}, language = {{eng}}, month = {{03}}, number = {{9}}, pages = {{654--662}}, publisher = {{Lippincott Williams & Wilkins}}, series = {{American Journal of Physical Medicine and Rehabilitation}}, title = {{The 1-Year Results of Lumbar Transforaminal Epidural Steroid Injection in Patients with Chronic Unilateral Radicular Pain : The Relation to MRI Findings and Clinical Features}}, url = {{http://dx.doi.org/10.1097/PHM.0000000000000730}}, doi = {{10.1097/PHM.0000000000000730}}, volume = {{96}}, year = {{2017}}, }