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The Efficacy of Transforaminal Epidural Steroid Injection by the Conventional Technique in Far-Lateral Herniation of Lumbar Disc

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Issue Date
2012-09
Publisher
American Society of Interventional Pain Physicians
Citation
PAIN PHYSICIAN Vol.15 No.5, pp. 415-420
Keywords
의약학Far lateral herniation of lumbar discintraspinal herniation of lumbar disctransforaminal epidural steroid injectionsafe triangleherniated lumbar discvisual analog
pain scale
Oswestry disability indexradiculopathy
Abstract
Background: Owing to the anatomical difference between the far lateral herniation of the lumbar disc (FHLD) and the intraspinal herniation of lumbar disc (iHLD), the outcome of transforaminal epidural steroid injections (TFESI) in patients with FHLD seems to be different from that in patients with iHLD. However, few studies have evaluated the efficacy of TFESI in FHLD.Objective: To evaluate and compare the efficacy of TFESI in FHLD and iHLD patients.Study Design: A retrospective design.Methods: There were 15 and 70 patients in the FHLD and iHLD groups, respectively. Patients received a fluoroscopically guided TFESI. Failure rates of TFESI were recorded, and questionnaires, including a visual analog scale (VAS) for leg pain and Oswestry Disability Index (ODI) were administered before the initial injection, at 2 weeks, 6 weeks, and 12 weeks after the injections.Results: There was no failure for TFESI in the iHLD group, while 9 patients had to undergo alternative blocks in the FHLD group due to lancinating leg pain when the needle was advanced for TFESI. In the iHLD group, there was a statistically significant improvement in the VAS and ODI score 12 weeks after injection. Considering only successful cases of the FHLD group, significant improvement in the VAS and ODI score was also demonstrated in the FHLD group 12 weeks after injection. Moreover, there was no statistically significant difference of the VAS and ODI between the both groups.Limitations: A relatively small numbers of cases were included in the FHLD group.Conclusion: The current study suggests that an alternative needle placement technique for TFESI appears to be necessary for FHLD patients.
ISSN
1533-3159
Language
English
URI
https://hdl.handle.net/10371/81998
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College of Medicine/School of Medicine (의과대학/대학원)Orthopedic Surgery (정형외과학전공)Journal Papers (저널논문_정형외과학전공)
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