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KMID : 0388720210280010001
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Journal of Korean Society of Spine Surgery
2021 Volume.28 No. 1 p.1 ~ p.12
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Lumbar Transforaminal Epidural Steroid Injection Using a Nerve Stimulator: The Effect of Needle Tip Position on Short-Term Effectiveness
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Lee Shi-Uk
Lee Chang-Han
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Abstract
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Study Design: Retrospective study.
Objectives: We aimed to determine the effect of needle tip position on the short-term effectiveness of transforaminal epidural steroid injection (TFESI) using a nerve stimulator (NS).
Summary of Literature Review: NS enables the needle to be located as close to the nerve root as possible; however, it is not known whether needle proximity affects the performance of TFESI.
Materials and Methods: Forty-five patients were grouped according to number of injected roots. Group I included patients administered TFESI in a single spinal nerve root, and the remainder belonged to group II. Needle tip positions were assessed by dividing the intervertebral foramen into 4 quadrants. Group A referred to all needle positions in quadrant 1 of the injected spinal nerve roots. Location of the needle tip in quadrants 2-4 in at least one spinal nerve root was seen in group B. The Oswestry Disability Index (ODI), Brief Pain Inventory (BPI), and residual pain (RP) were evaluated.
Results: After 2 weeks, a significant decrease in the ODI, BPI, and RP score was noted in all patients, as well as in group I and group II separately. In group I, changes in ODI and BPI scores were statistically significantly greater and RP scores improved to a significantly greater extent in patients who had their needle position in quadrant 1. In all patients, group A had a significant therapeutic effect than group B. In group II, there was no statistically significant difference between group A and group B.
Conclusions: Our study showed a better effect in quadrant 1 than in quadrant 2. NS guidance for TFESI is useful.
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KEYWORD
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Injections, Needle, Stimulator, Radicular pain
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