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Year : 2020  |  Volume : 8  |  Issue : 1  |  Page : 12-15

Role of transforaminal epidural steroid injection in chronic disc pain

Department of Orthopedics, Saveetha Medical College, Chennai, Tamil Nadu, India

Correspondence Address:
Dr. Jaganath Karunakaran
Department of Orthopedics, Saveetha Medical College, Saveetha Nagar, Thandalam, Chennai - 602 105, Tamil Nadu
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/joas.joas_49_19

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BACKGROUND: Chronic lower back pain is a chronic pain syndrome in the lower back region lasting for ≥12 weeks with the most common cause being intervertebral disc herniation. Epidural steroid injection is the most widely accepted treatment modality of all the surgical and non surgical methods at various sites such as translaminar, caudal, and transforaminal. It is ideal to start transforaminal epidural steroid injection (TFESI) early as chronic neural compression leads to irreversible changes in neural anatomy, which leads to a less favorable outcome. AIMS AND OBJECTIVES: To study the effectiveness of TFESI in chronic disc pain with radiculopathy in terms of duration of relief. MATERIALS AND METHODS: This is a retrospective study involving 50 patients with chronic disc pain who underwent fluoroscopic guidance TFESI in the year 2018 at Saveetha medical college. These patients are those who were administered TFESI under fluoroscopic guidance using 2ml of 40mg of Methylprednisolone with 1 ml of 2% xylocaine. Their initial pre injection and current pain scores were assessed using a visual analog scale (VAS score) by recording the medical history and follow-up, respectively. RESULTS: The most common level of involvement was L4/L5 (80%). The mean difference in VAS score was 3.14. The standard deviation of the mean difference in VAS score (σ) is 1.38. The mean duration of relief is 2.5 months. Around 14% (7 patients) did not have any relief in pain after the procedure. Around 76% of the patients were willing to recommend the procedure to others with a similar problem. Two individuals underwent surgery following the procedure, which suggests a failure of the procedure. CONCLUSION: TFESI is a very useful procedure for significant pain reduction in chronic disc pain involving a single level. In addition to corticosteroids, lignocaine is very useful in reducing local inflammation and pain due to its “washout effect.” Hence, TFESI with postoperative strengthening exercises is beneficial for short-term pain relief.

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