Abstracto

The effectiveness of computed tomography-guided lumbar epidural steroid injections for spinal pain management: A single center experience with 2-year follow-up

Ali Harman, Enes Duman, Adnan Ozdemir

Purpose: To determine the therapeutic value and long-term effects of Computed Tomography (CT)- guided translaminar and transforaminal lumbar epidural steroid injections for spinal pain management.

Materials and Methods: Between December 2011 and June 2013, 428 CT-guided epidural steroid injections of the lumbar spine for 310 patients were assessed retrospectively. There were 325 Translaminar (TL) (in 225 patients) and 103 Transforaminal (TF) (in 85 patients) injections performed. The clinical effectiveness of the injection after the therapy was assessed using Visual Analog Scale (VAS). The patients were classified into three groups (A-C) after injections according to the reduction in the VAS’s.

Results: Technical success rate of 100% without any major complication related to needle placement or drug administration. There were 27 (6.3%) reported minor complications (n: 3 orthostatic hypotension (0.7%) and n: 24 transient motor weaknesses of lower extremities (5.6%). The mean visual analog scores before and after the injections were recorded as 8.9 ± 1.1 and 4.8 ± 2.5 retrospectively (p<0.001). In 23 of 310 patients epidural injections were repeated in different times during study and 73 epidural injections (n: 61 TL and n: 12 TF) were performed.

Conclusion: CT guided epidural injection in the lumbar spine is safe, repeatable and efficacious pain management technique. Both translaminar and transforaminal epidural steroid injections can provide reliable pain relief for up to average 5.5 and 5.6 months respectively.