Does a Positive Response to Transforaminal Epidural Steroid Injection Identify Patients Who Can Avoid Surgery for Two Years?
Journal
Pain research & management
ISSN: 1918-1523
Titre abrégé: Pain Res Manag
Pays: United States
ID NLM: 9612504
Informations de publication
Date de publication:
2023
2023
Historique:
received:
11
05
2023
revised:
19
09
2023
accepted:
09
10
2023
medline:
1
11
2023
pubmed:
23
10
2023
entrez:
23
10
2023
Statut:
epublish
Résumé
Transforaminal epidural steroid injection (TFESI) is widely used to manage lumbar radiculopathy. In clinical settings, patients often undergo repeated transforaminal epidural injections with or without steroid administration. To examine whether a positive response to TFESI at the first month, can in clinical settings, identify patients with radiculopathy who can avoid surgery for two years. Individuals aged ≥20 years who had been referred to our pain center by spine surgeons were enrolled. All patients were assessed using the Numerical Rating Scale (NRS) at baseline and 1 month after the first TFESI. Patients were divided into two groups according to the NRS decrement: the positive response (PR) group achieved a ≥2.0 decrease on the NRS 1 month after the first TFESI compared to baseline and the no response (NR) group achieved a <2.0 decrease on the NRS. The incidence rates of surgery over two years were compared between the two groups. In addition, we calculated the hazard ratio of the PR group to the NR group regarding the incidence of surgery over two years using the Cox proportional hazard model, adjusting for baseline NRS. Seventy-six patients completed the two-year follow-up. In total, 8 and 68 patients had bilateral and unilateral radiculopathy, respectively. The PR and NR groups included 35 and 41 patients, respectively. The rate of surgery avoidance was 85.7% and 73.2% in the PR and NR groups, respectively. This difference was not statistically significant ( A positive response to TFESI may not identify patients who can avoid surgery for two years.
Sections du résumé
Background
UNASSIGNED
Transforaminal epidural steroid injection (TFESI) is widely used to manage lumbar radiculopathy. In clinical settings, patients often undergo repeated transforaminal epidural injections with or without steroid administration.
Objectives
UNASSIGNED
To examine whether a positive response to TFESI at the first month, can in clinical settings, identify patients with radiculopathy who can avoid surgery for two years.
Methods
UNASSIGNED
Individuals aged ≥20 years who had been referred to our pain center by spine surgeons were enrolled. All patients were assessed using the Numerical Rating Scale (NRS) at baseline and 1 month after the first TFESI. Patients were divided into two groups according to the NRS decrement: the positive response (PR) group achieved a ≥2.0 decrease on the NRS 1 month after the first TFESI compared to baseline and the no response (NR) group achieved a <2.0 decrease on the NRS. The incidence rates of surgery over two years were compared between the two groups. In addition, we calculated the hazard ratio of the PR group to the NR group regarding the incidence of surgery over two years using the Cox proportional hazard model, adjusting for baseline NRS.
Results
UNASSIGNED
Seventy-six patients completed the two-year follow-up. In total, 8 and 68 patients had bilateral and unilateral radiculopathy, respectively. The PR and NR groups included 35 and 41 patients, respectively. The rate of surgery avoidance was 85.7% and 73.2% in the PR and NR groups, respectively. This difference was not statistically significant (
Conclusion
UNASSIGNED
A positive response to TFESI may not identify patients who can avoid surgery for two years.
Identifiants
pubmed: 37869446
doi: 10.1155/2023/4298436
pmc: PMC10590266
doi:
Substances chimiques
Steroids
0
Types de publication
Observational Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
4298436Informations de copyright
Copyright © 2023 Aki Fujiwara et al.
Déclaration de conflit d'intérêts
The authors declare that there are no conflicts of interest.
Références
Syst Rev. 2015 Oct 01;4:132
pubmed: 26428467
Korean J Pain. 2019 Jul 1;32(3):147-159
pubmed: 31257823
Health Qual Life Outcomes. 2016 Mar 01;14:35
pubmed: 26931101
PM R. 2009 Jul;1(7):657-68
pubmed: 19627959
Medicine (Baltimore). 2020 Jul 24;99(30):e21283
pubmed: 32791709
Eur Spine J. 2009 Aug;18(8):1220-5
pubmed: 19387704
Spine J. 2017 Feb;17(2):236-243
pubmed: 27664340
Eur J Pain. 2004 Aug;8(4):283-91
pubmed: 15207508
Pain Pract. 2020 Feb;20(2):154-167
pubmed: 31538405
Reg Anesth Pain Med. 2013 May-Jun;38(3):175-200
pubmed: 23598728
Pain Physician. 2018 Sep;21(5):449-468
pubmed: 30282390
Pain Physician. 2016 Mar;19(3):E365-410
pubmed: 27008296
Qual Life Res. 2011 Dec;20(10):1727-36
pubmed: 21479777
Pain Physician. 2021 Aug;24(5):E539-E554
pubmed: 34323441
Niger J Clin Pract. 2020 Jun;23(6):835-841
pubmed: 32525120
J Cancer Res Clin Oncol. 2022 Sep;148(9):2549-2560
pubmed: 35788727
BMC Musculoskelet Disord. 2015 Feb 07;16:17
pubmed: 25887469
Br J Neurosurg. 2017 Apr;31(2):205-208
pubmed: 27548310
Spine (Phila Pa 1976). 2008 Nov 15;33(24):2663-8
pubmed: 18981962
J Anesth. 2023 Apr;37(2):261-267
pubmed: 36576588
Pain Med. 2020 Mar 1;21(3):472-487
pubmed: 31343693
Pain Physician. 2011 Jul-Aug;14(4):361-70
pubmed: 21785479
Cureus. 2019 Oct 17;11(10):e5934
pubmed: 31788391