Comparison of Transforaminal and Interlaminar Epidural Steroid Injection in Managing Lumbar Radiculopathy

Abstract

Purpose: Epidural steroid injection is a commonly used low risky symptomatic treatment option of lumbar radiculopathy in patients with poor response to conservative management. The purpose of this prospective study was to compare the efficacy of transforaminal and interlaminar epidural steroid injection. Materials and methods: In this study computed tomography guided lumbar epidural steroid injections were performed in 87 patients, steroid injections were made by transforaminal and interlaminar technique. The effectiveness of this treatment was evaluated by visual analogue scale at 2 weeks ( acute), 3 months (sub-acute) and 6 months ( chronic) after the injection. Results: In interlaminar group 78.1% patients had effective pain relief at acute term and 73.4% patients had effective pain relief at sub-acute and chronic term. In transforaminal group 82.6% patients had effective pain relief at acute term and 73.9% patients had effective pain relief at sub-acute and chronic term. Transforaminal group showed slightly better pain relief in all terms but the difference was not statistically significant. Patients with symptom duration more than 6 months had statistically significant higher pain relief than the patients with symptom duration less than 6 months in acute term but there was no statistically significant difference between sub-acute and chronic terms. Conclusion: In the current study transforaminal epidural steroid injections for the treatment of lumbar radiculopathy resulted in better pain relief than interlaminar epidural steroid injections in all terms but the difference was not statistically significant.