Department of Anesthesiology, All India Institute of Medical Sciences, Bhopal, India.
Department of Neurosurgery, All India Institute of Medical Sciences, Bhopal, India.
World Neurosurg. 2021 May;149:e392-e399. doi: 10.1016/j.wneu.2021.02.011. Epub 2021 Feb 9.
This retrospective study compares the results of 2 different techniques of transforaminal epidural steroid injection (TFESI)-subpedicular (SP-TFESI) and lateral recess epidural steroid injection (LRSI) in relieving chronic lumbar radicular pain.
Records of 97 patients who had undergone injection for unilateral lumbar radicular pain and had a paracentral disc were analyzed. Numerical rating scale (NRS) and Oswestry Disability Index (ODI) scores were measured at baseline and at 2, 4, 12, and 24 weeks thereafter.
At 24 weeks, the NRS was significantly lower than the baseline in both groups; NRS in the LRSI group was significantly lower than NRS in the SP-TFESI group at 12 and 24 weeks (P = 0.02 each). ODI score was also significantly lower in the LRSI group through the 12-week time point (P = 0.003 at 2 weeks; P = 0.009 at 4 weeks; P = 0.02 at 12 weeks). At the end of 24 weeks, a significantly greater number of patients in the LRSI group achieved minimal clinically important difference for NRS and ODI (P = 0.008 and 0.016, respectively).
At the end of 24 weeks, LRSI appears to be a superior technique in relieving unilateral lumbar radicular pain due to a paracentral disc.
本回顾性研究比较了经椎间孔硬膜外类固醇注射(TFESI)-椎弓根旁入路(SP-TFESI)和侧隐窝硬膜外类固醇注射(LRSI)两种不同技术缓解慢性腰椎根性疼痛的效果。
分析了 97 例单侧腰椎根性疼痛并伴有旁中央椎间盘的患者的记录。在基线和之后的 2、4、12 和 24 周测量数字评分量表(NRS)和 Oswestry 残疾指数(ODI)评分。
24 周时,两组的 NRS 均明显低于基线;LRSI 组的 NRS 在 12 和 24 周时明显低于 SP-TFESI 组(P 分别为 0.02)。LRSI 组的 ODI 评分在 12 周时也明显降低(P 分别为 2 周时 0.003,4 周时 0.009,12 周时 0.02)。在 24 周结束时,LRSI 组有更多的患者在 NRS 和 ODI 上达到最小临床重要差异(P 分别为 0.008 和 0.016)。
在 24 周结束时,LRSI 似乎是一种缓解旁中央椎间盘引起的单侧腰椎根性疼痛的更好技术。