Department of Pain Management, West China Hospital, Sichuan University, Chengdu, Sichuan Province, People's Republic of China; Department of Anesthesiology, People's Hospital of Qingbaijiang District, Chengdu, Sichuan Province, People's Republic of China.
Department of Anesthesiology, The Second People's Hospital of Chengdu, Chengdu, Sichuan Province, People's Republic of China.
Pain Physician. 2023 Jul;26(4):347-355.
The efficacy and its associated predictors of transforaminal epidural steroid injection (TFESI) in elderly patients with lumbar radiculopathy are unknown.
The purpose of this retrospective study was to identify the efficacy of TFESI in elderly patients with lumbar radiculopathy and its associated predictors of long-term outcomes.
Retrospective study.
Interventional pain clinics in West China Hospital of Sichuan University.
In total, 294 elderly patients who were diagnosed with lumbar radiculopathy and underwent transforaminal epidural steroid injections from January 2019 through January 2022 were retrospectively analyzed. Demographic, clinical, magnetic resonance imaging, and TFESI-related information was collected to assess the predictive factors of long-term outcomes of the TFESI. Pain scores were assessed using the Numeric Rating Scale. Treatment success was defined as a >= 50% reduction in pain scores at 6 months.
Multivariate logistic regression analysis revealed that the duration of symptoms, immediate postoperative response, and neutrophilic granulocyte percentage were independently associated with a favorable response to TFESI. In addition, the level of pain at the initial visit and the number of TFESI performed were also associated with a good response in the multivariate regression analysis, even though the association was not statistically significant.
Approximately 6% of the patients were lost to follow-up; therefore, selection bias may have slightly influenced our findings. In addition, our patients were not compared with a control population, and consequently, a placebo effect could not be assessed.
This study revealed that a short duration of symptoms, good immediate postoperative response and high neutrophilic granulocyte percentage were long-term predictors of a good response to TFESI in elderly patients with lumbar radiculopathy.
经椎间孔硬膜外类固醇注射（TFESI）治疗老年腰椎神经根病的疗效及其相关预测因素尚不清楚。
本回顾性研究的目的是确定 TFESI 治疗老年腰椎神经根病的疗效及其对长期结局的相关预测因素。
回顾性研究。
四川大学华西医院介入疼痛诊所。
共回顾性分析了 2019 年 1 月至 2022 年 1 月期间因腰椎神经根病接受经椎间孔硬膜外类固醇注射治疗的 294 名老年患者。收集人口统计学、临床、磁共振成像和 TFESI 相关信息，以评估 TFESI 长期结局的预测因素。疼痛评分采用数字评分量表评估。治疗成功定义为 6 个月时疼痛评分至少降低 50%。
多变量逻辑回归分析显示，症状持续时间、即刻术后反应和中性粒细胞百分比与 TFESI 反应良好独立相关。此外，在多变量回归分析中，初始就诊时的疼痛程度和 TFESI 的次数也与良好的反应相关，尽管关联没有统计学意义。
约有 6%的患者失访；因此，选择偏倚可能会略微影响我们的发现。此外，我们的患者没有与对照组进行比较，因此无法评估安慰剂效应。
本研究表明，症状持续时间短、术后即刻反应良好和中性粒细胞百分比高是老年腰椎神经根病患者 TFESI 反应良好的长期预测因素。
