Taskaynatan Mehmet Ali, Tezel Kutay, Yavuz Ferdi, Tan Arif Kenan
Department of Physical Medicine and Rehabilitation, Gülhane Military Medical Academy, TAF Rehabilitation Center, Ankara, Turkey.
Clinic of Physical Medicine and Rehabilitation, Military Hospital of Etimesgut, Ankara, Turkey.
J Back Musculoskelet Rehabil. 2015;28(3):447-51. doi: 10.3233/BMR-140539.
The aim of this retrospective study was to investigate the therapeutic effect of transforaminal epidural steroid injection in patients with chronic low back pain and radicular leg pain due to lumbar disc herniation.
This study included 80 patients (32 female and 48 male; mean age: 45.8 years [range: 25-65 years]) that received fluoroscopically guided transforaminal epidural steroid injections for chronic radicular low back pain due to lumbar disc herniation. All of the patients had diagnostic MRI findings and did not respond to conservative treatment. All injections were performed by the same physician at the interventional pain unit of a tertiary hospital. The effectiveness of transforaminal epidural steroid injections was assessed via a standardized telephone questionnaire administered 2 years after the first injection.
Mean duration of radicular low back pain was 24.50 ± 18.25 months. Most of the epidural injections were administered at the L5 and S1 levels. The most effective post-injection period was the first 5.11 ± 3.07 months. Mean duration of injection effect was 12.46 ± 7.24 months. The response rate to the epidural steroid injections was 72%.
There was negative correlation between the duration of treatment effect and the duration of pre-treatment symptoms. Additionally, clinical improvement of radicular low back pain increased significantly as the duration of pre-treatment symptoms decreased. Based on the present findings, we think that transforaminal epidural steroid injections can be used as an alternative treatment for managing chronic radicular low back pain.
本回顾性研究的目的是调查经椎间孔硬膜外类固醇注射治疗因腰椎间盘突出症导致慢性腰痛和腿部放射性疼痛患者的疗效。
本研究纳入80例患者（女性32例，男性48例；平均年龄：45.8岁[范围：25 - 65岁]），这些患者因腰椎间盘突出症导致慢性放射性腰痛，接受了在荧光镜引导下的经椎间孔硬膜外类固醇注射。所有患者均有诊断性MRI检查结果且对保守治疗无反应。所有注射均由一名医生在一家三级医院的介入疼痛科进行。经椎间孔硬膜外类固醇注射的有效性通过首次注射2年后进行的标准化电话问卷调查进行评估。
放射性腰痛的平均病程为24.50±18.25个月。大多数硬膜外注射在L5和S1水平进行。注射后最有效的时间段是最初的5.11±3.07个月。注射效果的平均持续时间为12.46±7.24个月。硬膜外类固醇注射的有效率为72%。
治疗效果的持续时间与治疗前症状的持续时间呈负相关。此外，随着治疗前症状持续时间的缩短，放射性腰痛的临床改善显著增加。基于目前的研究结果，我们认为经椎间孔硬膜外类固醇注射可作为治疗慢性放射性腰痛的一种替代疗法。
