BISE, Sylvain; LANGLET, Benjamin; PESQUER, Lionel; POUSSANGE, Nicolas; SILVESTRE, Alain; DALLAUDIERE, Benjamin

doi:10.1007/s00256-023-04290-y

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Skeletal Radiology. 2023-10-01, vol. 52, n° 10, p. 1959-1967

Résumé en anglais

To compare the efficacy of the transforaminal approach (TFA) versus the interlaminar approach (ILA) for CT-guided epidural steroid injection (CTESI) in the treatment of persistent lumbosacral radicular pain (LRP > 6 weeks) with long-term follow-up. Patients were prospectively assessed for pain by visual analogue scale (VAS) and functional disability (Oswestry Disability Index, (ODI)) before treatment, then 6 weeks (6W), 6 months (6 M), and 5 years (5Y) after CTESI. Overall, n = 237 patients (TFA, n = 71 and ILA, n = 166) were included, and 96 patients had 5 years of follow-up. Both groups showed a statistically significant improvement in VAS and ODI values at 6W (TFA, n = 60 and ILA, n = 146, P < 0.001 for both), at 6 M (TFA, n = 34 and ILA, n = 96, P < 0.001 for both), and at 5Y (TFA, n = 32 and ILA, n = 64, P < 0.001 for both). No significant differences were observed between the two approaches in VAS or ODI decreases at 6W (P = 0.38 and P = 0.33 respectively), 6 M (P = 0.13 and P = 0.51 respectively), or 5Y (P = 0.15 and P = 0.57 respectively). No major complications were noted. Outcomes after CTESI by ILA approaches are similar to those by TFA for the treatment of persistent LRP.< Réduire

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Humans

Prospective Studies

Follow-Up Studies

Treatment Outcome

Low Back Pain

Radiculopathy

Steroids

Tomography

X-Ray Computed

Injections

Epidural

Lumbar Vertebrae

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Transforaminal versus interlaminar CT-guided lumbar epidural steroid injections: prospective study of 237 patients with unilateral radicular pain and up to 5 years of follow-up

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