Turkish Neurosurgery
Optimal Timing and Outcome of Transforaminal Epidural Steroid Injection for the Management of Radicular Pain due to Extruded Lumbar Disc Herniation
Bulent Guclu1, Levent Deniz2, Salim Katar3, Ahmet Ozdemir3
1Ministry of Health, Lütki Lırdar Kartal Research and Training Hospital, Neurosurgery, İstanbul,
2Marmara Pain Center, Neurosurgery, İstanbul,
3Balikesir University, Faculty of Medicine, Neurosurgery, Balikesir,
DOI: 10.5137/1019-5149.JTN.43361-23.4

Aim:To evaluate the optimal timing and outcome of fluoroscopically guided transforaminal epidural steroid injections (TFESI) for the management of radicular pain due to extruded lumbar disc herniation (LDH).Material and Methods:In this clinical study, 305 individuals received fluoroscopically guided TFESI for the management of radicular pain due to extruded LDH. Preprocedural and 12-week postprocedural Visual Analog Scale (VAS) scores measuring radicular pain were statistically compared. The neurological conditions of the patients and the complications of the procedure were also recorded.Results:The intensity of radicular pain evaluated by the mean preprocedural and 12-week postprocedural VASs were 87.65 ± 5.59 and 22.81 ± 4.01, respectively. The P value was p:0.001 (p < 0.05) and t value was 119.01. A correlation was noted between the short duration of symptoms before the procedure and the effectiveness of the procedure. After 12 weeks of the procedure, 32 of the 58 patients showed improvement in a neurological deficit. There was no major complication. Nine patients required lumbar disc surgery after the procedure.Conclusion:This clinical research demonstrated that TFESI for the management of extruded LDH may alleviate radicular pain and may decrease the neurological deficit and that it is more effective when performed at the earliest possible time point.

Corresponding author : Bulent Guclu