The impact of transforaminal epidural steroid injections on pain severity and disability in lumbar disc herniation with radiculopathy: a vas and odi analysis

Introduction: Lumbar disc herniation with radiculopathy is a common cause of Low Back Pain (LBP) accompanied by leg discomfort, often originating from degenerative disc herniation. This study aimed to assess the impact of Transforaminal Epidural Steroid Injections (TFESIs) on pain severity and disability in these patients.

Aim and objectives: The study aimed to observe the effect of TFESIs on pain severity (assessed using Visual Analog Scale, VAS) and disability score (Oswestry Disability Index, ODI) in the management of lumbar disc herniation with radiculopathy.

Methodology: Patients over 18 years with confirmed lumbar disc herniation and radiculopathy via MRI were included, regardless of prior surgery or acute/recurrent disc herniations. Exclusion criteria encompassed acute injuries, neurological impairments, infectious causes, steroid allergies, and inconclusive MRI-clinical correlation. TFESIs were administered under fluoroscopic guidance, targeting the "safe triangle" above and lateral to the nerve root. Neural fiber-blocking agents like Xylocaine, Bupivacaine, and Triamcinolone were used. The choice of corticosteroid varied among practitioners. While severe complications were rare, minor issues like headaches were more common.

Results: The majority of participants were aged 36-55 years (68.3%), with a slight male predominance (55%). Symptoms included LBA with bilateral (20.0%), left (43.3%), or right (36.7%) lower limb radiculopathy. Most had symptoms for 4-6 months (40.0%). Pain severity, assessed using VAS, ranged from moderate to severe. Notably, ODI scores significantly decreased from baseline to 1 week, 3 weeks, 3 months, and 1 year post-treatment, indicating an improvement in disability levels.

Conclusion: Transforaminal Epidural Steroid Injections appear to be an effective intervention in managing lumbar disc herniation with radiculopathy. This study provides valuable insights into pain severity and disability reduction, suggesting its potential as a treatment option for patients suffering from this condition. Further research is needed to corroborate these findings.