Purpose: In this study, we evaluated the therapeutic outcomes of transforaminal epidural steroid injection (TFESI) in managing chronic radicular pain due to foraminal stenosis. Furthermore, we evaluated its effectiveness according to isthmic spondylolisthesis (IS) severity.
Patients And Methods: We included 40 patients with radicular pain due to IS-derived foraminal stenosis in our study and treated them with TFESI. Two patients were lost during follow-up. Based on the lateral lumbar radiograph findings, we allocated the recruited patients with < 25% slippage by IS to Group 1 (n = 23) and those having 25-50% slippage to Group 2 (n = 15). The degree of pain was measured using a numeric rating scale (NRS) at pre-treatment and 1 and 2 months after TFESI.
Results: In 38 patients who completed the study, the NRS at pre-treatment was significantly reduced at the 1- and 2-month follow-ups. In the Group analysis, the NRS scores were significantly reduced after TFESI in both Groups 1 and 2, regardless of IS severity. However, the reduction in NRS scores 1 month after TFESI was significantly greater in Group 1 than in Group 2. Moreover, the rate of successful treatment outcomes was significantly higher (65.2%) in Group 1 than in Group 2 (26.7%).
Conclusion: After TFESI, chronic radicular pain was significantly reduced regardless of IS severity, and its effect persisted for at least 2 months. However, its effect was superior when the vertebra slippage by IS was less than 25% compared to patients with 25%-50%.
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http://dx.doi.org/10.2147/JPR.S441358 | DOI Listing |
Anesth Pain Med (Seoul)
November 2024
Department of Anesthesia and Pain Medicine, Alfayoum University, Alfayoum, Egypt.
Background: Failed back surgery syndrome is a common problem faced by chronic pain management specialists. Steroid-only epidural injections have modest efficacy because of excessive scarring. Epidural hyaluronidase (HA), functions as a depolymerizing agent, successfully breaking down adhesions and collagen bundles, whereas dexmedetomidine (DEX) helps to reduce inflammation.
View Article and Find Full Text PDFAnesth Pain Med (Seoul)
January 2025
Department of Anesthesia, Intensive Care and Pain Medicine, Faculty of Medicine, Alfayoum University, Alfayoum, Egypt.
Background: Epidural steroid injections are frequently used to treat chronic radicular pain of a discogenic origin; however, their efficacy remains limited. Magnesium sulfate and dexmedetomidine are emerging adjuvants with the potential to enhance the effectiveness and prolong the therapeutic duration of steroid injections.
Methods: In this randomized, double-blind study, 90 patients with unilateral lower limb radiculopathy due to lumbar disc prolapse who did not respond to conservative treatment for 12 weeks were assigned to three groups.
SAGE Open Med Case Rep
January 2025
Department of Orthopaedic Surgery, UPMC Central PA, Harrisburg, PA, USA.
Paraspinal hematomas are common complications following spine surgery. In general, these hematomas are asymptomatic and resolve without issue. Unfortunately, there is a paucity of literature that describes the recurrence of these hematomas in a chronic setting.
View Article and Find Full Text PDFGlobal Spine J
January 2025
Department of Neurosurgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Study Design: Systematic Review.
Objectives: Formalized terminology for pain experienced by spine cancer patients is lacking. The common descriptors of spine cancer pain as mechanical or non-mechanical is not exhaustive.
Neurosciences (Riyadh)
January 2025
From the Department of Algology (Göksu), Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, from the Department of Algology (Celik, Akcaboy, Şahin), University of Health Sciences Ankara City Hospital, Ankara, from Ankara Gaziler PMR Training and Research Hospital (Baran), University of Health Sciences, Ağrı, from the Department of Algology (Yıldız), University of Health Sciences Ankara Etlik City Hospital, Ankara, from the Department of Algology (Kaya), Adıyaman University Training and Research Hospital, Adıyaman, and from the Department of Algology (Ayhan), Dumlupinar University Kutahya Evliya Celebi Training and Research Hospital, Kütahya, Turkey.
Objectives: To compare the effectiveness of preganglionic transforaminal epidural steroid injection (TFESI) with preganglionic plus postganglionic TFESI.
Methods: Patients with unilateral radicular pain and disc pathology were randomly assigned to either the preganglionic group or the preganglionic plus postganglionic group. All patients were evaluated using a numeric rating scale (NRS) and a patient satisfaction scale (PSS) at the third week and the third month after treatment.
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