Article

OBJECTIVE: To identify demographic and clinical factors associated with pain
improvement after a lumbosacral transforaminal epidural steroid injection (TFESI)
for the treatment of radicular pain. DESIGN: Retrospective cohort study. SETTING:
Outpatient center. PARTICIPANTS: Adults (N=188) who underwent a fluoroscopically
guided TFESI for lumbosacral radicular pain. INTERVENTIONS: Not applicable. MAIN
OUTCOME MEASURES: Pain reduction from preinjection to 2-week follow-up was
measured by visual analog scale (VAS). Patients were grouped by those who
experienced no pain relief or worsened pain (</=0%), pain relief but <50% relief
(>0%-<50%), or significant pain relief (>/=50%) on the VAS. RESULTS: The mean
duration of pain prior to injection was 45.8+/-81 weeks. The mean time to
follow-up after TFESI was 20+/-14.2 days. Significantly more patients who
experienced >/=50% pain relief at follow-up reported higher preinjection pain on
the VAS (P=.0001) and McGill Pain Inventory Questionnaire (P=.0358), reported no
worsening of their pain with walking (P=.0161), or had a positive femoral stretch
test (P=.0477). No significant differences were found between VAS pain reduction
and all other demographic and clinical factors, including a radiologic diagnosis
of disk herniation versus stenosis or other neural tension signs on physical
examination. CONCLUSIONS: Greater baseline pain on the VAS and McGill Pain
Inventory, a history of a lack of worsening pain with walking, and a positive
femoral stretch test predict a greater likelihood of pain reduction after TFESI
for lumbosacral radicular pain at short-term follow-up. Greater baseline pain on
the McGill Pain Inventory and a lack of worsening pain with walking predict a
magnitude of >50% pain reduction.
CI - Copyright (c) 2014 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS