Article

In patients with chronic radicular pain, we aimed to evaluate subgroup
differences in 1-yr response to transforaminal epidural steroid injection.
DESIGN: In this longitudinal cohort study of 100 subjects,
170 transforaminal
epidural steroid injections were performed for 1 yr.
The sample was stratified by
type of disc herniation (protrusion n = 57,
extrusion n = 27), by location of
disc herniation (central/subarticular n = 60, foraminal n = 24), by grade of
nerve root compression (low-grade compression n = 61,
high-grade subarticular
nerve compression n = 14, high-grade foraminal nerve compression n = 25), and by
positive Slump test (n = 67). Treatment response was evaluated by visual analogue
scale leg pain and self-reported disability (Oswestry Disability Index). Logistic
regression was used to analyze the predictive value of baseline characteristics
including the stratified subgroups. RESULTS: High-grade subarticular nerve
compression predicted the 1-yr improvement in both visual analogue scale leg pain
(P = 0.046) and Oswestry Disability Index (P = 0.027). Low age (P < 0.001), short
duration of leg pain (P = 0.015), and central/subarticular disc herniation (P =
0.017) predicted improvement in Oswestry Disability Index. CONCLUSIONS: In
patients treated with one or several transforaminal epidural steroid injections
due to chronic lumbar radicular pain, clinical findings failed to predict the 1-yr treatment response.
Low age, short duration of leg pain, central/subarticular disc herniation, and high-grade subarticular nerve
compression predicted a favorable 1-yr response to transforaminal epidural steroid injection.

Langue : ANGLAIS