Manakul Park, Siribumrungwong Koopong, Dhanachanvisith Naphakkhanith
Department of Orthopedics, Faculty of Medicine, Thammasat University, Pathum Thani 12120, Thailand.
Chulabhorn International College of Medicine, Thammasat University, Pathum Thani 12120, Thailand.
J Clin Med. 2023 Jul 17;12(14):4727. doi: 10.3390/jcm12144727.
This study evaluated the short-term spinal sagittal alignment change after transforaminal epidural steroid injection (TFESI) in lumbar spinal stenosis patients. Patients with lumbar spinal stenosis who underwent TFESI were retrospectively examined. Clinical outcomes were assessed using the Visual Analog Scale (VAS) and Oswestry Disability Index (ODI). Before and two weeks after the intervention, whole-spine lateral standing view radiographs were taken. Radiographic parameters including the Sagittal Vertical Axis (SVA), C2C7 Cobb, Thoracic Kyphosis (TK), Lumbar Lordosis (LL), Pelvic Incidence (PI), Pelvic Tilt (PT), Sacral Slope (SS), and Lumbopelvic Mismatch (PI-LL) were measured. Ninety-nine patients (mean age 64.3 ± 9.2 years) were included in this study. Both VAS and ODI outcomes were statistically improved after two weeks of intervention. Radiographic parameters showed that SVA, PT, and PI-LL mismatch were significantly decreased, while C2C7 Cobb, TK, SS, and LL were significantly increased after the intervention. SVA was improved by 29.81% (52.76 ± 52.22 mm to 37.03 ± 41.07 mm, < 0.001). PT also decreased significantly from 28.71° ± 10.22° to 23.84° ± 9.96° ( < 0.001). Transforaminal epidural steroid injection (TFESI) significantly improves VAS, ODI, and global sagittal parameters in lumbar spinal stenosis patients.
本研究评估了腰椎管狭窄症患者经椎间孔硬膜外类固醇注射(TFESI)后短期脊柱矢状面排列变化。对接受TFESI的腰椎管狭窄症患者进行回顾性检查。使用视觉模拟量表(VAS)和Oswestry功能障碍指数(ODI)评估临床结果。在干预前和干预后两周拍摄全脊柱站立位侧位X线片。测量包括矢状垂直轴(SVA)、C2C7 Cobb角、胸椎后凸(TK)、腰椎前凸(LL)、骨盆入射角(PI)、骨盆倾斜角(PT)、骶骨倾斜角(SS)和腰骶骨盆失配(PI-LL)在内的影像学参数。本研究纳入了99例患者(平均年龄64.3±9.2岁)。干预两周后,VAS和ODI结果在统计学上均有改善。影像学参数显示,干预后SVA、PT和PI-LL失配显著降低,而C2C7 Cobb角、TK、SS和LL显著增加。SVA改善了29.81%(从52.76±52.22 mm改善至37.03±41.07 mm,<0.001)。PT也从28.71°±10.22°显著降至23.84°±9.96°(<0.001)。经椎间孔硬膜外类固醇注射(TFESI)可显著改善腰椎管狭窄症患者的VAS、ODI和整体矢状面参数。