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Outcome of Transforaminal Epidural Steroid Injection According to Severity of Cervical Foraminal Stenosis.

World Neurosurgery 2018 Februrary
BACKGROUND: Cervical transforaminal epidural steroid injection (TFESI) is considered one of the most effective treatments for radicular pain induced by cervical foraminal stenosis.

PURPOSE AND DESIGN: We sought to evaluate the treatment outcome of TFESI according to the severity of cervical foraminal stenosis. In our retrospective study there were 53 patients with cervical radiculopathy due to cervical foraminal stenosis.

OUTCOME MEASURES: Pain intensity was evaluated using a numeric rating scale (NRS) at pretreatment, 2 weeks, and 1, 2, and 3 months after TFESI.

METHODS: Patients were divided into 2 groups according to the severity of stenosis by cervical axial magnetic resonance imaging findings. Twenty-two patients were assigned to group A (nonsevere stenosis), and 31 patients were assigned to group B (severe stenosis).

RESULTS: Thirty-seven (69.8%) of 53 patients showed successful treatment outcome (>50% reduction in the NRS score at 3 months). The patients in both groups showed a significant decrease in NRS scores at 2 weeks and at 1, 2, and 3 months after TFESI. However, the effect of TFESI was not significantly different between patients with nonsevere cervical foraminal stenosis and those with severe cervical foraminal stenosis.

CONCLUSIONS: The treatment outcome of cervical TFESI did not different according to the severity of cervical foraminal stenosis. However, on the basis of our results, we suggest that TFESI can be a beneficial clinical option for managing radicular pain due to cervical foraminal stenosis.

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