Yıl: 2017 Cilt: 63 Sayı: 2 Sayfa Aralığı: 117 - 123 Metin Dili: İngilizce İndeks Tarihi: 29-07-2022

The effectiveness of transforaminal epidural steroid injection in patients with radicular low back pain: Combination of pain provocation with effectiveness results

Öz:
This study aims to investigate the efficacy of transforaminal epidural steroid injection (TFESI) on low back pain relief and functionalimpairments and whether pain provocation during injection has an effect on pain relief in mid-term.Patients and methods: The study, which was conducted between September 2012 and September 2013, included 62 patients with low back pain(38 males, 24 females; median age 45 years; min 22 - max 88 years). All injections were applied under C-arm fluoroscopy guidance, using a mix ofbetamethasone and lidocaine. A 100 mm Visual Analog Scale (VAS) for pain, Oswestry Disability Index (ODI), and Short Form-36 were administeredbefore the injection, and at post-injection second and 12th weeks. Presence of any pain provocation was questioned during injection.Results: The most frequent level of intervention was L5 level. Median initial VAS score was 80.0 (50.0;100.0) mm, which was measured as45.0 (0.0;90.0) mm and 30.0 (0.0;100.0) mm at the post-injection second and 12th weeks, respectively. Median initial ODI score was 25.0 (9.0;43.0)points, which was measured as 17.0 (3.0;38.0) and 12.5 (1.0;38.0) points at the post-injection second and 12th weeks, respectively. All subgroup scoresof SF-36 improved significantly during the follow-up period. We detected statistically significant improvements in the outcome measurements at thepost-injection second and 12th weeks (p<0.05). There were significant differences between patients with positive and moderate pain provocation interms of VAS (p=0.004) and ODI (p=0.006) scores.Conclusion: In this follow-up study, transforaminal epidural steroid injection was found to be effective in both the early period and in the mid-term.Pain provocation was not clinically predictive for better outcome according to the results.
Anahtar Kelime:

Konular: Rehabilitasyon
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Woolf AD, Pfleger B. Burden of major musculoskeletal conditions. Bull World Health Organ 2003;81:646-56.
  • 2. Juniper M, Le TK, Mladsi D. The epidemiology, economic burden, and pharmacological treatment of chronic low back pain in France, Germany, Italy, Spain and the UK: a literaturebased review. Expert Opin Pharmacother 2009;10:2581-92.
  • 3. Hoy D, Bain C, Williams G, March L, Brooks P, Blyth F, et al. A systematic review of the global prevalence of low back pain. Arthritis Rheum 2012;64:2028-37.
  • 4. Konstantinou K, Dunn KM. Sciatica: review of epidemiological studies and prevalence estimates. Spine (Phila Pa 1976) 2008;33:2464-72.
  • 5. MacVicar J, King W, Landers MH, Bogduk N. The effectiveness of lumbar transforaminal injection of steroids: a comprehensive review with systematic analysis of the published data. Pain Med 2013;14:14-28.
  • 6. Riew KD, Yin Y, Gilula L, Bridwell KH, Lenke LG, Lauryssen C, et al. The effect of nerve-root injections on the need for operative treatment of lumbar radicular pain. A prospective, randomized, controlled, double-blind study. J Bone Joint Surg [Am] 2000;82:1589-93.
  • 7. Riew KD, Park JB, Cho YS, Gilula L, Patel A, Lenke LG, et al. Nerve root blocks in the treatment of lumbar radicular pain. A minimum five-year follow-up. J Bone Joint Surg [Am] 2006;88:1722-5.
  • 8. McCormick Z, Margolis S, Temme K, Rivers E, Cameron SA, Smith MC, et al. Concordant pain provocation during transforaminal epidural steroid injection for lumbosacral radiculopathy: effect on pain outcome and predictive factors. Pain Physician 2015;18:19-26.
  • 9. Plastaras CT HD, Sorosky BS, Houle TT. Pain reproduction during lumbosacral transforaminal epidural steroid injection does not affect outcome. J Back Musculoskelet Rehabil 2006;19:57-60.
  • 10. Ghahreman A, Ferch R, Bogduk N. The efficacy of transforaminal injection of steroids for the treatment of lumbar radicular pain. Pain Med 2010;11:1149-68.
  • 11. April C, Bogduk N, Dreyfuss P, Endres S, Govind J, Kraft M, et al, editors. Practice Guidelines for Spinal Diagnostic & Treatment Procedures. 1st ed. San Francisco: International Spine Intervention Society; 2004.
  • 12. Gracely RH. Pain measurement. Acta Anaesthesiol Scand 1999;43:897-908.
  • 13. Vela LI, Haladay DE, Denegar C. Clinical assessment of lowback-pain treatment outcomes in athletes. J Sport Rehabil 2011;20:74-88.
  • 14. Fairbank JC, Pynsent PB. The Oswestry Disability Index. Spine (Phila Pa 1976) 2000;25:2940-52.
  • 15. Roland M, Fairbank J. The Roland-Morris Disability Questionnaire and the Oswestry Disability Questionnaire. Spine (Phila Pa 1976) 2000;25:3115-24.
  • 16. Beurskens AJ, de Vet HC, Köke AJ, van der Heijden GJ, Knipschild PG. Measuring the functional status of patients with low back pain. Assessment of the quality of four disease-specific questionnaires. Spine (Phila Pa 1976) 1995;20:1017-28.
  • 17. Ware JE, Kosinski M, Keller JL, editors. SF-36 Physical and Mental Health Summary Scales: A User’s Manual. Boston, MA: The Health Institute; 1994.
  • 18. Vad VB, Bhat AL, Lutz GE, Cammisa F. Transforaminal epidural steroid injections in lumbosacral radiculopathy: a prospective randomized study. Spine (Phila Pa 1976) 2002;27:11-6.
  • 19. Kaufmann TJ, Geske JR, Murthy NS, Thielen KR, Morris JM, Wald JT, et al. Clinical effectiveness of single lumbar transforaminal epidural steroid injections. Pain Med 2013;14:1126-33.
  • 20. Çetin MF, Karaman H, Ölmez Kavak G, Tüfek A, Baysal Yildirim Z. Efficacy of transforaminal lumbar epidural steroid injections in patients with lumbar radiculopathy. [Article in Turkish] Agri 2012;24:77-84.
  • 21. Kennedy DJ, Dreyfuss P, Aprill CN, Bogduk N. Paraplegia following image-guided transforaminal lumbar spine epidural steroid injection: two case reports. Pain Med 2009;10:1389-94.
  • 22. Plastaras C, McCormick ZL, Garvan C, Macron D, Joshi A, Chimes G, et al. Adverse events associated with fluoroscopically guided lumbosacral transforaminal epidural steroid injections. Spine J 2015;15:2157-65.
APA Adiguzel E, Tecer D, GÜZELKÜÇÜK Ü, Taskaynatan M, TAN A (2017). The effectiveness of transforaminal epidural steroid injection in patients with radicular low back pain: Combination of pain provocation with effectiveness results. , 117 - 123.
Chicago Adiguzel Emre,Tecer Duygu,GÜZELKÜÇÜK Ümüt,Taskaynatan Mehmet Ali,TAN ARİF KENAN The effectiveness of transforaminal epidural steroid injection in patients with radicular low back pain: Combination of pain provocation with effectiveness results. (2017): 117 - 123.
MLA Adiguzel Emre,Tecer Duygu,GÜZELKÜÇÜK Ümüt,Taskaynatan Mehmet Ali,TAN ARİF KENAN The effectiveness of transforaminal epidural steroid injection in patients with radicular low back pain: Combination of pain provocation with effectiveness results. , 2017, ss.117 - 123.
AMA Adiguzel E,Tecer D,GÜZELKÜÇÜK Ü,Taskaynatan M,TAN A The effectiveness of transforaminal epidural steroid injection in patients with radicular low back pain: Combination of pain provocation with effectiveness results. . 2017; 117 - 123.
Vancouver Adiguzel E,Tecer D,GÜZELKÜÇÜK Ü,Taskaynatan M,TAN A The effectiveness of transforaminal epidural steroid injection in patients with radicular low back pain: Combination of pain provocation with effectiveness results. . 2017; 117 - 123.
IEEE Adiguzel E,Tecer D,GÜZELKÜÇÜK Ü,Taskaynatan M,TAN A "The effectiveness of transforaminal epidural steroid injection in patients with radicular low back pain: Combination of pain provocation with effectiveness results." , ss.117 - 123, 2017.
ISNAD Adiguzel, Emre vd. "The effectiveness of transforaminal epidural steroid injection in patients with radicular low back pain: Combination of pain provocation with effectiveness results". (2017), 117-123.
APA Adiguzel E, Tecer D, GÜZELKÜÇÜK Ü, Taskaynatan M, TAN A (2017). The effectiveness of transforaminal epidural steroid injection in patients with radicular low back pain: Combination of pain provocation with effectiveness results. Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi, 63(2), 117 - 123.
Chicago Adiguzel Emre,Tecer Duygu,GÜZELKÜÇÜK Ümüt,Taskaynatan Mehmet Ali,TAN ARİF KENAN The effectiveness of transforaminal epidural steroid injection in patients with radicular low back pain: Combination of pain provocation with effectiveness results. Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi 63, no.2 (2017): 117 - 123.
MLA Adiguzel Emre,Tecer Duygu,GÜZELKÜÇÜK Ümüt,Taskaynatan Mehmet Ali,TAN ARİF KENAN The effectiveness of transforaminal epidural steroid injection in patients with radicular low back pain: Combination of pain provocation with effectiveness results. Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi, vol.63, no.2, 2017, ss.117 - 123.
AMA Adiguzel E,Tecer D,GÜZELKÜÇÜK Ü,Taskaynatan M,TAN A The effectiveness of transforaminal epidural steroid injection in patients with radicular low back pain: Combination of pain provocation with effectiveness results. Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi. 2017; 63(2): 117 - 123.
Vancouver Adiguzel E,Tecer D,GÜZELKÜÇÜK Ü,Taskaynatan M,TAN A The effectiveness of transforaminal epidural steroid injection in patients with radicular low back pain: Combination of pain provocation with effectiveness results. Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi. 2017; 63(2): 117 - 123.
IEEE Adiguzel E,Tecer D,GÜZELKÜÇÜK Ü,Taskaynatan M,TAN A "The effectiveness of transforaminal epidural steroid injection in patients with radicular low back pain: Combination of pain provocation with effectiveness results." Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi, 63, ss.117 - 123, 2017.
ISNAD Adiguzel, Emre vd. "The effectiveness of transforaminal epidural steroid injection in patients with radicular low back pain: Combination of pain provocation with effectiveness results". Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi 63/2 (2017), 117-123.