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Transforaminal epidural steroid injection

Alaa-Eldin Adel El Maadawy, Alaa Mazy, Mohamed El Mitwalli Mansour El Adrosy, Ashraf Abdel-Moneim El-Mitwalli, Ayman Mohamed Abd El Naby, Mohammad Gomma
Background: Low back pain (LBP) is one of the most common musculoskeletal abnormalities. Epidural corticosteroid injections (ESIs) have been used long time ago for treatment of lumbar radiculopathy or discogenic back pain in case of failed medical and conservative management. Different techniques for ESIs include the interlaminar, the caudal, and the transforaminal approaches. Purpose: The aim of our study is to compare between the efficacy of infraneural transforaminal ESI and lumbar paramedian nerve root targeted interlaminar steroid injection in reduction of unilateral radicular pain secondary to disc prolapse...
October 2018: Saudi Journal of Anaesthesia
Jung Hwan Lee, Kyoung-Ho Shin, Sung Jin Park, Goo Joo Lee, Chang-Hyung Lee, Dong Hwan Kim, Du Hwan Kim, Hee Seung Yang
BACKGROUND: Epidural injection (EI) is used to treat back or radicular pain from lumbosacral disc herniation (LDH). Although several reports have stated that the transforaminal approach in EI (TFEI) has an advantage in target specificity and yields better clinical efficacy than the interlaminar approach in EI (ILEI), other studies have indicated that the clinical efficacy of ILEI was not inferior to that of TFEI and that ILEI also has the ability to spread medication into the ventral space to a degree similar to that of TFEI...
September 2018: Pain Physician
Serdar Kesikburun, Berke Aras, Bayram Kelle, Ferdi Yavuz, Evren Yaşar, Mehmet A Taşkaynatan
AIM: To investigate the long-term effect of fluoroscopy guided cervical transforaminal epidural steroid injection on neck pain radiating to the arm due to cervical disc herniation. MATERIALS & METHODS: 64 patients (26 women [40.6%], 38 men [59.4%]; mean age, 44.9 ± 12.1 years) who had received fluoroscopy guided cervical transforaminal epidural steroid injection for neck pain due to cervical disc herniation at least 1 year before were included in the study...
October 3, 2018: Pain Management
Semih Gungor, Asli Ozcan
RATIONALE: Perineural cysts, commonly referred to as Tarlov cysts, are cerebrospinal fluid-filled dilations between the perineurium and endoneurium typically arising at the junction of posterior and dorsal root ganglia in the neural foramina. This anatomical location is in close proximity to usual needle trajectory during performing transforaminal epidural injection, and therefore presents a potential risk of dural puncture and associated complications. PATIENT CONCERNS: Severe lower extremity pain interfering with activities of daily living...
September 2018: Medicine (Baltimore)
Martin J Wilby, Carolyn Hopkins, Emma Bedson, Sue Howlin, Girvan Burnside, Elizabeth J Conroy, Dyfrig A Hughes, Manohar Sharma, Anthony Marson, Simon R Clark, Paula Williamson
BACKGROUND: Sciatica is a common condition reported to affect over 3% of the UK population at any time and is often caused by a prolapsed intervertebral disc (PID). Although the duration and severity of symptoms can vary, pain persisting beyond 6 weeks is unlikely to recover spontaneously and may require investigation and treatment. Currently, there is no specific care pathway for sciatica in the National Health Service (NHS), and no direct comparison exists between surgical microdiscectomy and transforaminal epidural steroid injection (TFESI)...
September 5, 2018: Trials
Ramsis F Ghaly, Thomas Zouki, Aby Pynadath, Kenneth D Candido, Nebojsa Nick Knezevic
Background: Chronic low back pain (LBP) is highly prevalent and costly in our society. The use of epidural steroid injections (ESIs) for the treatment of radicular LBP is very widespread and continues to rise. The most popular injection is the lumbar/sacral transforaminal epidural steroid injection (TFESI). Here, we present a serious neurological complication resulting from such a TFESI that was only reversed by timely neurosurgical intervention. Case Description: A 49-year-old male presented with a 5-year history of progressive neurogenic claudication and right lower extremity pain/radiculopathy...
2018: Surgical Neurology International
In Chan Baek, Su Youn Choi, Jiwoo Suh, Shin Hyung Kim
OBJECTIVES: To evaluate the influence of the depth of local anesthesia application on procedural pain during lumbar transforaminal epidural steroid injection (TFESI). DESIGN: Sixty-eight patients were enrolled who were scheduled for single-level, unilateral fluoroscopically-guided lumbar TFESI. Patients were randomly allocated to receive either subcutaneous local anesthesia (group S) or deep local anesthesia (group D) for TFESI. The data related to pain and technical performance during the procedure was compared...
August 27, 2018: American Journal of Physical Medicine & Rehabilitation
Yuanyuan Ding, Hongxi Li, Yongqiang Zhu, Peng Yao, Guangyi Zhao
Background: Lumbar disc herniation (LDH) is a common disease in clinical practice. The symptoms recur and are aggravated by time; severe pain and long-term movement disorder cause physiological and psychological problems that affect the quality of life of patients. Therefore, relieving the pain symptoms and promoting functional recovery are the primary goals that have gained increased attention. Objective: To assess the efficacy of CT-guided transforaminal epidural steroid injection (TFESI) combined with pulsed radio frequency (PRF) on spinal nerve root for the treatment of LDH...
2018: Journal of Pain Research
Kai-Uwe Lewandrowski
OBJECTIVE: To analyze the positive predictive value of diagnostic 1% lidocaine containing transforaminal epidural steroid injections (TESI) for successful outcome after outpatient endoscopic decompression for lumbar foraminal and lateral recess stenosis. PATIENTS AND METHODS: A retrospective study of 1839 consecutive patients with an average mean follow-up of 33 months that underwent endoscopic transforaminal decompression at 2076 lumbar levels was conducted. The sensitivity, specificity, and positive predictive value of lidocaine containing diagnostic TESI at the intended surgical level were calculated based on the recorded frequency of >50% VAS score reduction, intraoperatively visualized stenosis, and clinical outcomes assessed by Macnab criteria and VAS reduction...
October 2018: Clinical Neurology and Neurosurgery
Dong-Yeong Lee, Young-Jin Park, Kun-Tae Kim, Jeong-Hee Lee, Dong-Hee Kim
Epidural steroid injection is one of the most commonly used non-surgical treatments for degenerative lumbar vertebral disease. Its use has increased as degenerative lumbar vertebral disease has increased in frequency. Concomitant complications are being reported more often. In this report, we report a rare case of iatrogenic hemorrhagic cyst following epidural steroid injection. The patient underwent operative treatment with complete resolution of his symptoms.
July 30, 2018: Acta Orthopaedica et Traumatologica Turcica
Aki Fujiwara, Keisuke Watanabe, Keiji Hashizume, Kozue Shinohara, Masahiko Kawaguchi
BACKGROUND: The acute phase of shingles is characterized by severe pain, and one of the complications of shingles known as postherpetic neuralgia (PHN) is associated with prolonged pain. Although factors predicting the development of PHN, as well as its preventative measures, have been investigated, there is no single treatment effective for PHN. Some studies showed effectiveness of epidural injection to alleviate pain associated with acute-phase shingles. In these studies, epidural injection was performed by interlaminar (IL) approach...
July 2018: Pain Physician
Sylvain Bise, Lionel Pesquer, Mathieu Feldis, Myriam Bou Antoun, Alain Silvestre, Arnaud Hocquelet, Benjamin Dallaudière
INTRODUCTION: The treatment of persistent cervical radicular pain (CRP) by CT-guided epidural steroid injections (CTESI) by a transforaminal anterolateral (TFA) approach is associated with rare but serious complications. Two recently described transforaminal posterolateral (TFP) and transfacet indirect (TFT) approaches may be safer options, but have not been extensively evaluated. We compared the efficacy of three CTESI approaches (TFA, TFP, and TFT) in the treatment of persistent CRP (>6 weeks)...
December 2018: Skeletal Radiology
Jung Hwan Lee, Kyoung-Ho Shin, Sung Jin Bahk, Goo Joo Lee, Dong Hwan Kim, Chang-Hyung Lee, Du Hwan Kim, Hee Seung Yang, Sang-Ho Lee
BACKGROUND CONTEXT: Epidural steroid injection has been used to treat back or radicular pain from lumbar and lumbosacral disc herniation (LDH). However, the superiority of transforaminal injection (TFESI) to caudal injection (CESI) remains controversial. PURPOSE: This systematic review and meta-analysis aimed to investigate whether TFESI was more useful than CESI for achieving clinical outcomes in patients with LDH. STUDY DESIGN/SETTING: A systematic review and/or is not appropriate...
July 18, 2018: Spine Journal: Official Journal of the North American Spine Society
Marissa Nichole Lassere, Kent Robert Johnson, Jeanette Thom, Grant Pickard, Peter Smerdely
INTRODUCTION: Acute sciatica (symptom duration less than 4 weeks), a major cause of pain and disability, is a common presentation to medical practices and hospital emergency departments. Selective CT fluoroscopy transforaminal epidural steroid injection is often used with the hope of reducing pain and improving function. Recently, there has been interest in using systemic corticosteroids in acute sciatica. However, there is limited evidence to inform management of selective CT fluoroscopy transforaminal epidural steroid in subacute and chronic sciatica and there is no evidence in acute sciatica, even though the practice is widespread...
July 5, 2018: BMJ Open
Nityanand Miskin, Glenn C Gaviola, Varand Ghazikhanian, Jacob C Mandell
OBJECTIVE: To determine the effect of needle position and foraminal stenosis on contrast flow directionality during CT-guided transforaminal epidural steroid injections (TFESI). MATERIALS AND METHODS: One hundred five consecutive CT-guided injections were performed in 68 patients (mean age, 65.5 years) from January 1 to December 31 2017, all with preceding MRI. Two readers independently reviewed CT images to assess needle position and to determine direction of contrast flow, which was defined as central or peripheral...
June 18, 2018: Skeletal Radiology
Onur Levent Ulusoy, Deniz Alis, Ayhan Mutlu, Bulent Colakoglu, Mustafa Sirvanci
BACKGROUND: Computed tomography (CT)-guided cervical nerve injections are broadly being used in the treatment of cervical radiculopathy; however, catastrophic complications have been reported. Herein, we aimed to evaluate the efficacy, feasibility, and safety of a novel CT-guided cervical injection technique. MATERIALS AND METHODS: We prospectively performed cervical injections in 28 patients with cervical radiculopathies using a novel CT-guided cervical transforaminal injection technique; lateral peri-isthmic approach in which the tip of the needle advanced to the lateral cortex of the isthmus instead of the foraminal area...
June 7, 2018: Skeletal Radiology
Won-Joong Kim, Hwa-Yong Shin, Seung Hee Yoo, Hahck Soo Park
BACKGROUND: The effect of transforaminal epidural steroid injection (TFESI) appears to be influenced by the volume of the injected material because there is a positive correlation between injection volume and extent of pain relief. OBJECTIVES: The purpose of this study was to examine how many vertebral segments are covered by the subpedicular (SP) approach and the retrodiscal (RD) approach and to compare the clinical outcomes of the 2 approaches in TFESI with high-volume injectates...
May 2018: Pain Physician
Gi-Young Park, Dong Rak Kwon, Dae Gil Kwon
RATIONALE: We report a case of a 61-year-old patient who developed complex regional pain syndrome (CRPS) type II after a cervical transforaminal epidural steroid injection (CTESI). PATIENT CONCERNS: The patient developed sudden-onset severe pain and swelling of his upper right limb after a cervical transforaminal epidural injection. DIAGNOSES: On physical examination, the patient's symptoms and signs corresponded to the Budapest criteria for CRPS...
May 2018: Medicine (Baltimore)
Zachary L McCormick, Vinil N Shah
No abstract text is available yet for this article.
October 2018: PM & R: the Journal of Injury, Function, and Rehabilitation
Duygu Tecer, Emre Adiguzel, Ozlem Koroglu, Arif Kenan Tan, Mehmet Ali Taskaynatan
OBJECTIVE: To investigate the relationship between epidurographic contrast dispersal patterns and both immediate and short-term clinical effectiveness of lumbar transforaminal epidural steroid injections (TFESIs) in patients with radicular back pain. METHODS: A digital database of 64 patients who underwent single-level lumbar TFESI for unilateral lumbar radicular pain was scanned. The type of contrast pattern was analyzed by 1 physiatrist and defined as follows: type 1 (tubular appearance), type 2 (nerve root visible as a filling defect), or type 3 (cloud-like appearance)...
August 2018: World Neurosurgery
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