Diagnosis and Treatment of Transforaminal Epidural Steroid Injection in Lumbar Spinal Stenosis

Objectives: Transforaminal epidural steroid injection reduces the low back-leg pain and enables daily activities of the patients. In this study, we aim to evaluate the treatment of transforaminal epidural steroid injection for lumbar spinal stenosis, which was mainly performed for lumbar disc herniation and share our diagnostic experience for lumbar spinal stenosis which is treated surgically.
Methods: In our study, 37 patients were included who were treated by transforaminal epidural steroid injection for Grade B lumbar spinal stenosis in our clinic between June-2014 and June-2018. We evaluated the patients at the second weeks, third/sixth months and one year after the treatment by Oswestry-Disability-Index and Visual-Analogue-Scale and followed up for surgical treatment after one year.
Results: The mean low back and leg pain Visual Analogue Scale was 5.1±0.3 before the transforaminal epidural steroid injection procedure, and it was 2.7±0.1 after two weeks. It was 2.8±0.2, 3.1±0.1 at three and six months after procedure, respectively. The improvement of low back-leg pain mean Visual-Analogue-Scale is statistically significant at two weeks, three and six months after transforaminal epidural steroid injection procedure, respectively. The mean Oswestry-Disability-Index was 29.6±0.4 before the transforaminal epidural steroid injection procedure, and it was 14.1±0.3 after two weeks. It was 15.3±0.5, 24.4±0.2 at three and six months after procedure, respectively. The improvement of Oswestry-Disability-Index is statistically significant at two weeks, three-six months.
Conclusion: The transforaminal epidural steroid injection is safe procedure for non-surgical treatment of lumbar spinal stenosis and this procedure may be preferred support to the indication of the surgical treatment of level of lumbar spinal stenosis.

Transforaminal epidural steroid enjeksiyonunun lomber spinal stenozda taný ve tedavi uygulamasý

Giriþ: Transforaminal epidural steroid enjeksiyonu uygulamasý bel ve bacak aðrýsý þikayetini azaltmakta ve günlük aktiviteye dönmeyi saðlamaktadýr. Çalýþmamýzda yaygýn olarak lomber disk hernisi tedavisi için uygulanan transforaminal epidural steroid enjeksiyonunun lomber spinal stenoz tedavisinde uygulanmasýný inceledik ve lomber spinal stenozda tanýsal yaklaþýmdaki tecrübelerimizi ortaya koyduk.
Yöntem: Çalýþmamýza; Haziran 2014 ile Haziran 2018 arasýnda kliniðimizde Evre B lomber spinal stenoz tanýsý ile transforaminal epidural steroid enjeksiyonu uygulanan 37 hasta dahil edildi. Hastalar uygulama öncesinde ve uygulamadan sonra 2.hafta ve 3./6. ay ve 1. yýlda Oswestry Disability Index and Visual Analog Skala ile deðerlendirildi. Uygulamadan bir yýl sonra cerrahi tedavi yönünden incelendi.
Bulgular: Hastalarýn ortalama Visual Analog Skalasý uygulama öncesinde 5.1±0.3, iki hafta sonra 2.7±0.1, 3 ay sonra 2.8±0.2 ve 6 ay sonra 3.1±0.1 idi. Visual Analog Skalasýndaki iyileþmenin uygulama öncesine göre 2 hafta sonra ve sýrasý ile 3 ve 6 aydaki deðiþiminin istatistiksel olarak anlamlý olduðu tespit edildi. Ortalama Oswestry Disability Index’I uygulama öncesi ve sýrasý ile 2 hafta sonra, 3,6 ay sonra 29.6±0.4, 14.1±0.3, 15.3±0.5, 24.4±0.2 idi. Oswestry Disability Index deðiþiminin de uygulama öncesine göre istatistiksel olarak anlamlý olduðu tespit edildi.
Sonuç: Transforaminal epidural steroid enjeksiyonu, lomber spinal stenozun cerrahi olmayan tedavisi için güvenli uygulamadýr ve bu uygulama lomber spinal stenozun cerrahi tedavi tanýsýna destek olarak tercih edilebilir. (SETB-2019-12-153)