Efficacy Of Transforaminal Epidural Steroid Injections in Lumbar Radicular Pain.

BACKGROUND

We aimed to investigate the efficacy of lumbar transforaminal epidural steroid injection therapy in patients with radicular low back pain that had not been alleviated by conservative management strategies.

METHODS

This study included 252 patients with radiculopathy due to lumbar disc herniation who failed conservative treatment. This is a retrospective cohort study. Participants (aged 18-90) underwent C-arm fluoroscopy-guided transforaminal epidural steroid injections (TFESI) using a subpedicular approach. Pain severity and functional status were evaluated at baseline, 2 weeks, and 3 months post-procedure using the Visual Analog Scale (VAS) and the Oswestry Disability Index (ODI). Statistical analysis focused on sociodemographic characteristics and longitudinal changes in VAS and ODI scores.

RESULTS

Out of 252 patients, 221 completed the full 3-month follow-up (mean age 54.5 ± 14.1 years; 57.5% female). The median symptom duration was 5 months, and the most frequent injection levels were L4-5 (51.1%) and L5-S1 (48.4%). Significant improvements were observed in both pain (VAS) and functional status (ODI) at the 2-week and 3-month months (p < 0.001). At the 3-month follow-up, treatment success (defined as >50%improvement) was achieved in 64.3% of patients for pain at rest, 57.5% for pain during movement, and 74.2% for nocturnal pain. Additionally, 55.7% of patients demonstrated a significant reduction in disability according to ODI scores.

CONCLUSION

TFESI is an effective non-operative treatment intervention that provides significant mid-term pain reduction and functional improvement in a substantial proportion of patients with lumbar radiculopathy. The low rate of surgical conversion suggests its value as a key alternative to surgery.

CLINICAL TRIALS NUMBER: NCT07538765.