Turkish Neurosurgery 2020 , Vol 30 , Num 3
Transforaminal Epidural Steroid Injection in the Treatment of Pain in Foraminal and Paramedian Lumbar Disc Herniations
Bulent GUCLU1,Levent DENIZ2,Yucel YUCE3,Utku ADILAY4,Hamit AYTAR5,Meryem TURKOGLU6,Mehmet TIRYAKI1,Recep OZDEK4,Burak Orhan BORAN1
1Kartal Dr. Lutfi Kirdar Training and Research Hospital, Department of Neurosurgery, Istanbul, Turkey
2Marmara Pain Management Center, Bakirkoy, Istanbul, Turkey
3Kartal Dr. Lutfi Kirdar Training and Research Hospital, Department of Anaesthesiology and Reanimation, Istanbul, Turkey
4Balikesir University School of Medicine, Department of Neurosurgery, Balikesir, Turkey
5Neurosurgery Clinic, Aile Hospital, Bahcelievler, Istanbul, Turkey
6Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Director of Nursing, Istanbul, Turkey
DOI : 10.5137/1019-5149.JTN.27220-19.3 AIM: To compare the effect of fluoroscopically guided transforaminal epidural steroid injections on radicular pain in foraminal and paramedian lumbar disc herniations.

MATERIAL and METHODS: This study included patients who did not benefit from previous medical treatments or are not suitable for surgery. Transforaminal epidural steroid injections for the treatment of foraminal and paramedian lumbar disc herniation were performed in 370 and 1262 patients, respectively. Every group’s preprocedural visual analogue scale (VAS) and 12-week postprocedural VAS scores were recorded, and statistical analysis was performed. The complications noted were also recorded.

RESULTS: The preprocedural and postprocedural mean VAS scores for radicular pain in foraminal disc herniation were 67.11 ± 4.28 and 34.78 ± 3.64, respectively. However, the preprocedural and postprocedural mean VAS scores in paramedian disc herniation were 62.16 ± 6.65 and 19.07 ± 4.50, respectively. Statistical analysis of the varying preprocedural and postprocedural VAS scores showed that transforaminal epidural steroid injections were more effective for paramedian disc herniation than for foraminal disc herniation (p<0.05).

CONCLUSION: Transforaminal epidural steroid injections were more effective for paramedian lumbar disc herniation than for foraminal disc herniation, 12 weeks after the procedure. Keywords : Disc herniation, Foraminal, Lumbar, Paramedian, Transforaminal, Epidural steroid injection

Corresponding author : Utku ADILAY, utkuadilay@hotmail.com