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KMID : 0361420110350030395
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Journal of Korean Academy of Rehabilitation Medicine
2011 Volume.35 No. 3 p.395 ~ p.404
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Usefulness of Posterolateral Transforaminal Approach in Lumbar Radicular Pain
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Park Ji-Woong
Nam Hee-Seung
Park Yong-Bum
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Abstract
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Objective: To compare the short-term eff ects and advantages of transforaminal epidural steroid injection (TFESI) performed using the conventional (CL) and posterolateral (PL) approaches.
Method: Fifty patients with lumbar radicular pain from lumbar spinal stenosis and herniated lumbar disc were enrolled. Subjects were randomly assigned to one of two groups (CL or PL group). All procedures were performed using a C-arm (KMC 950, KOMED, Kwangju, Kyunggi, Korea). We compared the frequency of complications during the procedure and the effects of the pain block between the two groups at 2, 4, and 12 weeks after the procedure.
Results: There were no significant differences in the demographic data, initial VNS (Visual numeric scale), or ODI (Oswestry disability index) between the CL group (n=26) and the PL group (n=24). Th ere was no statistically signifi cant diff erence in the outcome measures (VNS and ODI) between the groups at 2, 4, or 12 weeks. Symptoms of nerve root irritation occurred in 1 case of the CL group and in 7 cases of the PL group (p<0.05). Pricking of spinal nerve during the procedure and transient weakness after the procedure occurred in 6 cases and 3 cases, respectively in the CL group, but did not occur in the PL group.
Conclusion: Our fi ndings suggest that the posterolateral approach represents an alternative TFESI method in cases with diffi cult needle tip positioning in the anterior epidural space, and could lower the risk of target nerve root irritation and nerve penetration.
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KEYWORD
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Transforaminal, Conventional, Posterolateral, Injection
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