THE RELATIONSHIP OF THE CLINICAL RESULTS OF THE PATIENTS UNDERGOING TRANSFORAMINAL EPIDURAL INJECTION WITH PREOPERATIVE MAGNETIC RESONANCE IMAGING FINDINGS

Bilal Aykaç, Abdullah Küçükalp
2022 The Journal of Turkish Spinal Surgery  
Objective: Lumbar disc herniation (LDH) is a common cause of low back pain and lumbar radiculopathy. In this study, the relationship between clinical results and pre-procedural magnetic resonance imaging (MRI) findings of patients with LDH-related radiculopathy symptoms who underwent lumbar transforaminal epidural steroid injection (TFESI) was evaluated. Materials and Methods: Between 2017 and 2021, 65 patients who were diagnosed as having LDH clinically and radiologically and underwent new MRI
more » ... examination at the latest 3 months before the procedure were included in the study. In the operating room, under the scopy imaging, 1 cc opaque substance (iohexol) was diluted with 5 cc isotonic solution and 1.5-2 cc of this was injected into the area for confirmation in the scopy vision. Then 1 cc betamethasone and 4 cc 2% prilocaine hydrochloride were mixed, and 5 cc of this was injected. Pain scoring was evaluated with visual analog scale (VAS) and disability was evaluated with oswestry disability index (ODI). Pre-procedural MRIs were examined and grouped according to Michigan State University classification. Results: The patients' median VAS and ODI scores were 8 [interquartile range (IQR): 7-8] and 74 (IQR: 67-77) before treatment; 2 (IQR: 1-3) and 14 (IQR: 10-29) in the 2 nd week; and 2 (IQR: 1-4) and 16 (IQR: 4-40) in the 3 rd month, respectively. It was determined that there was a statistically significant change in the pain and disability levels of the patients over time (ANOVA type test statistics=338,743, degree of freedom=1,542, p-value<0.001). It was determined that the change observed in VAS and ODI scores over time did not show a statistically significant difference according to disc type and location. Conclusion: The TFESI is a treatment method that can be used safely, independent of the disc type and localization in the MRI performed before the procedure.
doi:10.4274/jtss.galenos.2022.76486 fatcat:owv5x4ljvzbdlavyp3urmlxfym