Comparison of transforaminal and interlaminar epidural steroid injections for the treatment of chronic lumbar pain

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• 作者：Serbü ; lent Gö ; khan Beyaz ^{sgbeyaz@gmail.com}
• 关键词：Transforaminal ; Interlaminar ; Low back pain ; Spinal injection ; Complication
• 刊名：Brazilian Journal of Anesthesiology (English Edition)
• 出版年：2017
• 出版时间：January-February 2017
• 年：2017
• 卷：67
• 期：1
• 页码：21-27
• 全文大小：480 K
• 卷排序：67

文摘

A cross-sectional study.ObjectiveWe compared the 12 month outcomes of fluoroscopically guided transforaminal epidural steroid injections with interlaminar epidural steroid injections for the treatment of chronic lumbar spinal pain. Chronic lower back pain is a multifactorial disorder with many possible etiologies. The lifetime prevalence of spinal pain is reportedly 65–80% in the neck and lower back. Epidural injection of corticosteroids is a commonly used intervention for managing chronic spinal pain.MethodsPatients who did not benefit from previous treatments were included in this study. Injections were performed according to magnetic resonance imaging findings at the nearest level of lumbar pathology; 173 patients received interlaminar epidural steroid injections and 126 patients received transforaminal epidural steroid injections. All of the patients were regularly followed up for 12 months using a verbal numeric rating scale. Magnetic resonance imaging findings, complications, verbal numeric rating scale, and satisfaction scores were recorded.ResultsLumbar disk pathology was the most frequently encountered problem. The interlaminar epidural steroid injections were preferred at the L4–L5 intervertebral level. Verbal numeric rating scale scores significantly decreased during the 12-month period compared to basal scores (p < 0.001). Significant differences between the two groups according to verbal numeric rating scale and satisfaction scores were not observed (p > 0.05). There were no major complications; however, the interlaminar epidural steroid injections group had 22 (12.7%) minor complications, and the transforaminal epidural steroid injections group had 12 (9.5%) minor complications.ConclusionsThis study showed that interlaminar epidural steroid injections can be as effective as transforaminal epidural steroid injections when performed at the nearest level of lumbar pathology using fluoroscopy in 12-month intervals.