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Transforaminal injection

Fei Wang, Qian Zhou, Lizu Xiao, Juan Yang, Donglin Xong, Disen Li, LiPing Liu, Sigdha Ancha, Jianguo Cheng
BACKGROUND: We demonstrated a combination of pulsed radiofrequency (PRF) and cervical nerve root block (CNRB) via a posterior approach was superior to a transforaminal epidural steroid injection through the anterolateral approach for cervical radicular pain in a previous study. This randomized trial was conducted to determine the comparative efficacy between CNRB, PRF, and CNRB + PRF for cervical radicular pain. METHODS: A prospective and randomized design was used in this study...
October 14, 2016: Pain Practice: the Official Journal of World Institute of Pain
Serbülent Gökhan Beyaz
STUDY DESIGN: A cross-sectional study. OBJECTIVE: we compared the 12 month outcomes of fluoroscopically guided transforaminal epidural steroid injections with interlaminar epidural steroid injections for the treatment of chronic lumbar spinal pain. Chronic lower back pain is a multifactorial disorder with many possible etiologies. The lifetime prevalence of spinal pain is reportedly 65-80% in the neck and lower back. Epidural injection of corticosteroids is a commonly used intervention for managing chronic spinal pain...
September 30, 2016: Revista Brasileira de Anestesiologia
Duygu Tecer, Emre Adiguzel, Arif Kenan Tan, Mehmet Ali Taskaynatan
OBJECTIVE:  To explore the outcome differences of lumbar transforaminal epidural steroid injection (TFESI) according to magnetic resonance imaging (MRI) findings in patients with lumbar radicular pain. DESIGN:  Retrospective study. SETTING:  Single university-based interventional pain management unit. PATIENTS:  Fifty-nine patients who had lumbar radicular pain with a recent lumbar MRI and three-month follow-up were included...
October 2, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Marco Lechmann, Andrea Rosskopf, Christine Ehrmann, Reto Sutter, Christian W A Pfirrmann, Cynthia K Peterson
OBJECTIVES: To determine whether specific MRI findings are related to outcomes after lumbar transforaminal epidural steroid injections (TFESI) and to assess the inter-rater reliability of imaging diagnosis. MATERIALS AND METHODS: A prospective outcomes study on 156 consecutive patients with 1-month follow-up outcomes data and MRI within 3 months of TFESI was conducted. Pain levels (numerical rating scale) (NRS) were recorded prior to injection. Overall 'improvement' was determined using the Patients Global Impression of Change (PGIC) scale and NRS data were collected at three time points post injection...
September 28, 2016: Skeletal Radiology
Fabrice Michel, Arnaud Dupeyron, Jean Jacques Labat, Etienne Aleton, Bernard Parratte
OBJECTIVE: Among pelvitrochanteric muscles, the internal obturator muscle is implicated in some pain projected at the buttock or perineum. Even though the pathophysiology is not completely understood, its responsibility is often held in clinical practice and in the literature due to effectiveness of botulinum toxin injections, constituting a therapeutic test. The objective is to enhance the couple ultrasound/EMG in difficult injections. MATERIAL/PATIENTS AND METHODS: Eighteen patients were treated in the physical medicine department (Besançon) from September 2015 to February 2016 for gluteal or perineal pain suspected to be related to abnormal spasm of the internal obturator muscle...
September 2016: Annals of Physical and Rehabilitation Medicine
Annalisa P Liotta, Maud Girod, Dominique Peeters, Charlotte Sandersen, Thierry Couvreur, Géraldine Bolen
OBJECTIVE To determine clinical effects of CT-guided lumbosacral facet joint, transforaminal epidural, and translaminar epidural injections of methylprednisolone acetate in healthy dogs. ANIMALS 15 healthy Beagles. PROCEDURES Dogs were randomly assigned to 3 groups (5 dogs/group) and received a single CT-guided lumbosacral facet joint, transforaminal epidural, or translaminar epidural injection of methylprednisolone acetate (0.1 mg/kg). Contrast medium was injected prior to injection of methylprednisolone to verify needle placement...
October 2016: American Journal of Veterinary Research
Holger Joswig, Armin Neff, Christina Ruppert, Gerhard Hildebrandt, Martin Nikolaus Stienen
No abstract text is available yet for this article.
September 15, 2016: World Neurosurgery
Ritesh Arvind Pandey
INTRODUCTION: Epidural steroid is an important modality in the conservative management of prolapsed lumbar disc and is being used for over 50 years. However, controversy still persists regarding their effectiveness in reducing the pain and improving the function with literature both supporting and opposing them are available. AIM: To study the efficacy of epidural steroid injection in the management of pain due to prolapsed lumbar intervertebral disc and to compare the effectiveness between caudal, transforaminal and interlaminar routes of injection...
July 2016: Journal of Clinical and Diagnostic Research: JCDR
Tae Keun Park, Sung Joon Shin, Jae Hyup Lee
STUDY DESIGN: This is a retrospective case-control study. OBJECTIVE: To evaluate the influence of medication-related bleeding tendency on the clinical outcomes and complications of transforaminal epidural steroid injection (TFESI). SUMMARY OF BACKGROUND DATA: TFESI may result in serious complications such as epidural hematoma or adhesions in patients with medication-related bleeding tendency. However, little is known about the true relationship between medication-related bleeding tendency and postprocedural complications...
September 10, 2016: Clinical Spine Surgery
Jaspal R Singh, Eliana Cardozo, George C Christolias
BACKGROUND: Epidural steroid injections have been used in combination with other modalities for the treatment of lumbar radicular pain. The literature has shown that 1-level lumbar fluoroscopically guided transforaminal epidural steroid injections (TFESIs) are effective in decreasing pain and morbidity; however, the efficacy of 2-level TFESIs has not been investigated, although they are performed by many practitioners in the treatment of lumbar radicular pain. OBJECTIVES: To assess the clinical effectiveness of 2-level TFESIs in patients with unilateral, single-level lumbar radicular pain...
September 7, 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Laxmaiah Manchikanti, Kavita N Manchikanti, Christopher G Gharibo, Alan D Kaye
CONTEXT: Lumbar post-surgery syndrome is common and often results in chronic, persistent pain and disability, which can lead to multiple interventions. After failure of conservative treatment, either surgical treatment or a nonsurgical modality of treatment such as epidural injections, percutaneous adhesiolysis is often contemplated in managing lumbar post surgery syndrome. Recent guidelines and systematic reviews have reached different conclusions about the level of evidence for the efficacy of epidural injections and percutaneous adhesiolysis in managing lumbar post surgery syndrome...
April 2016: Anesthesiology and Pain Medicine
Korgün Ökmen, Burcu Metin Ökmen
BACKGROUND CONTEXT: Epidural steroid injection is commonly used in patients with chronic low back pain. Applying a mixture of alocal anesthetic (LA) and steroid using the interlaminar (IL), transforaminal (TF), and caudal techniques is a preferred approach. PURPOSE: The present study aims to investigate the efficacy of IL epidural steroid (LES) administration in patients with multi-level lumbar disc pathology (LDP), and to assess the possible correlation of the procedure success with age and body mass index (BMI)...
August 20, 2016: Spine Journal: Official Journal of the North American Spine Society
Niel Davis, Patrick Hourigan, Andrew Clarke
BACKGROUND CONTEXT: Transforaminal epidural steroid injection (TFESI) is recognised as a treatment for symptomatic lumbar disc herniation, whilst surgical decompression is generally thought to be the most effective treatment option for lumbar spinal stenosis. There is little available literature examining the effect of TFESI on symptomatic lumbar spinal stenosis. PURPOSE: To evaluate the use of TFESI as an alternative to surgery in patients with symptomatic stenosis...
August 22, 2016: British Journal of Neurosurgery
Gerritt M Lagemann, Patrick W Aldred, Amir A Borhani, Anish Ghodadra, Vikas Agarwal
OBJECTIVE: Planning imaging performed during CT-guided procedures may occasionally contain important incidental findings. The purpose of this study was to identify and characterize by clinical relevance the extraspinal findings detected on planning imaging for CT-guided lumbar transforaminal epidural steroid injections (TFESIs). MATERIALS AND METHODS: Four radiologists retrospectively evaluated the planning scout views and CT studies for 488 consecutive CT-guided lumbar TFESIs performed in 400 patients over a 1-year period...
August 17, 2016: AJR. American Journal of Roentgenology
Dong Gyu Lee, Sang-Ho Ahn, Jungwon Lee
Transforaminal Epidural steroid injections (TFESI) have been widely adopted to alleviate and control radicular pain in accord with current guidelines. However, sometimes repeated steroid injections have adverse effects, and thus, this prospective randomized trial was undertaken to compare the effectivenesses of pulsed radiofrequency (PRF) administered to a targeted dorsal root ganglion (DRG) and TFESI for the treatment of radicular pain due to disc herniation. Subjects were recruited when first proved unsuccessful (defined as a score of > 4 on a visual analogue scale (VAS; 0-10 mm) and of > 30% according to the Oswestry Disability Index (ODI) or the Neck Disability Index (NDI))...
August 2016: Journal of Korean Medical Science
Hossein Elgafy, Nicholas Peters, Justin E Lea, Robert M Wetzel
A 64-year-old-female presented with progressive left foot weakness, low back and radicular pain after a left sided S1 transforaminal epidural steroid injection (ESI). Magnetic resonance imaging revealed left side L5-S1 large extradural heterogeneous mass with layering areas suggesting different stages of hematoma formation. Past medical history was significant for peripheral vascular disease and transient ischemic attacks, for which she took aspirin and clopidogrel (antiplatelet agent). These medications were discontinued one week prior to ESI...
July 18, 2016: World Journal of Orthopedics
Sung-Jun Hong, Dae Yu Kim, Hyunju Kim, Seok Kim, Keun-Man Shin, Sang-Soo Kang
BACKGROUND: Although herniated disc fragments may resolve spontaneously, the optimal treatment option for massive lumbar disc herniation (LDH) has not been determined. OBJECTIVE: To evaluate the extent of reduction in the size of massive LDH on magnetic resonance imaging (MRI) and the pain relief effect of transforaminal epidural steroid injection (TFESI) during the study period. STUDY DESIGN: Retrospective evaluation. SETTING: Hospital and ambulatory pain clinic, Korea...
July 2016: Pain Physician
Jeetinder Kaur Makkar, Preet Mohinder Singh, Divya Jain, Basavana Goudra
BACKGROUND: The efficacy of particulate and non-particulate steroids in patients receiving epidural steroid injections remains unclear. OBJECTIVE: The purpose of this meta-analysis was to compare the efficacy of particulate and non-particulate steroids in patients receiving epidural injections for radicular pain over 3 months. STUDY DESIGN: Systematic review and meta-analysis. METHODS: We reviewed PubMed, PubMed Central, Scopus, Central Register of Clinical Trials of the Cochrane Collaboration, Google Scholar, and Directory of open access journals for trials that compared efficacy of particulate steroid with non-particulate...
July 2016: Pain Physician
Jung Hwan Lee, Sang-Ho Lee
Epidural steroid injection (ESI) is known to be an effective treatment for neck or radicular pain due to herniated intervertebral disc (HIVD) and spinal stenosis (SS). Although repeat ESI has generally been indicated to provide more pain relief in partial responders after single ESI, there has been little evidence supporting the usefulness of this procedure. The purpose of this study, therefore, was to determine whether repeat ESI at a prescribed interval of 2 to 3 weeks after the first injection would provide greater clinical benefit in patients with partial pain reduction than intermittent ESI performed only when pain was aggravated...
July 2016: Medicine (Baltimore)
T J Amrhein, N T Befera, L Gray, P G Kranz
BACKGROUND AND PURPOSE: Epidural blood patch treatment of spontaneous intracranial hypotension arising from ventral CSF leaks can be difficult secondary to challenges in achieving ventral spread of patching material. The purpose of this study was to determine the technical success rates and safety profile of direct needle placement into the ventral epidural space via a posterior transforaminal approach. MATERIALS AND METHODS: We retrospectively reviewed consecutive CT fluoroscopy-guided epidural blood patches from June 2013 through July 2015...
July 7, 2016: AJNR. American Journal of Neuroradiology
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