Clinical evaluation of transforaminal epidural steroid injection in patients with gadolinium enhancing spinal nerves associated with disc herniation
Transforaminal epidural steroid injection (TFESI) of corticosteroid is frequently employed to mitigate the painful and disabling symptoms of lumbar disc herniation. However, the treatment outcome of TFESI in patients with radicular pain and inflamed neural structures as assessed by contrast-enhanced...
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| Veröffentlicht in: | Pain physician 2015-03, Vol.18 (2), p.E177-E185 |
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| creator | Tak, Hyeong-Jun Jones, Rodney Cho, Yun-Woo Kim, Eun-Hyuk Ahn, Sang-Ho |
| description | Transforaminal epidural steroid injection (TFESI) of corticosteroid is frequently employed to mitigate the painful and disabling symptoms of lumbar disc herniation. However, the treatment outcome of TFESI in patients with radicular pain and inflamed neural structures as assessed by contrast-enhanced magnetic resonance imaging (MRI) has not been forthcoming.
To investigate functional improvement and pain reduction following TFESI in patients found to have nerve inflammation as evidenced by gadolinium-enhanced (MRI).
Retrospective assessment.
Tertiary spinal intervention center, Daegu, Korea.
Thirty-seven patients were selected by strict inclusion criteria. Patients were classified into enhancing and non-enhancing groups as evidenced by gadolinium-enhanced MRI. The enhancing group was further divided into pre-dorsal roog ganglion (DRG) only enhanced group and pre-DRG and post-DRG enhanced group. Clinical outcomes were evidenced by numeric rating scale (NRS) and Oswestry disability index (ODI) at pretreatment, one week, and 4 weeks after treatment.
The improvement of NRS and ODI in the enhanced group was greater than those of the non-enhanced group, at one week and 4 weeks after TFESI (P < 0.05). However there was no significant difference in improvement of NRS and ODI between pre-DRG only enhanced group and pre-DRG and post-DRG enhanced group at one week and 4 weeks after TFESI.
Retrospective chart review with a small sample size.
The improvement of NRS and ODI in the enhanced group was significantly greater than those of the non-enhanced group after TFESI. Radicular pain and functional impairment in the presence of gadolinium enhancing spinal neural structures and lumbar disc herniation may be more responsive to TFESI than patients without enhancing neural structures. |
| doi_str_mv | 10.36076/ppj/2015.18.E177 |
| format | Article |
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To investigate functional improvement and pain reduction following TFESI in patients found to have nerve inflammation as evidenced by gadolinium-enhanced (MRI).
Retrospective assessment.
Tertiary spinal intervention center, Daegu, Korea.
Thirty-seven patients were selected by strict inclusion criteria. Patients were classified into enhancing and non-enhancing groups as evidenced by gadolinium-enhanced MRI. The enhancing group was further divided into pre-dorsal roog ganglion (DRG) only enhanced group and pre-DRG and post-DRG enhanced group. Clinical outcomes were evidenced by numeric rating scale (NRS) and Oswestry disability index (ODI) at pretreatment, one week, and 4 weeks after treatment.
The improvement of NRS and ODI in the enhanced group was greater than those of the non-enhanced group, at one week and 4 weeks after TFESI (P < 0.05). However there was no significant difference in improvement of NRS and ODI between pre-DRG only enhanced group and pre-DRG and post-DRG enhanced group at one week and 4 weeks after TFESI.
Retrospective chart review with a small sample size.
The improvement of NRS and ODI in the enhanced group was significantly greater than those of the non-enhanced group after TFESI. Radicular pain and functional impairment in the presence of gadolinium enhancing spinal neural structures and lumbar disc herniation may be more responsive to TFESI than patients without enhancing neural structures.</description><identifier>ISSN: 1533-3159</identifier><identifier>EISSN: 2150-1149</identifier><identifier>DOI: 10.36076/ppj/2015.18.E177</identifier><identifier>PMID: 25794217</identifier><language>eng</language><publisher>United States: American Society of Interventional Pain Physician</publisher><subject>Adult ; Epidural ; Female ; Gadolinium ; Humans ; Injections, Epidural - methods ; Injections, Epidural - standards ; Intervertebral Disc Displacement - diagnosis ; Intervertebral Disc Displacement - drug therapy ; Lumbar Vertebrae - pathology ; Magnetic resonance imaging ; Magnetic Resonance Imaging - methods ; Magnetic Resonance Imaging - standards ; Male ; Middle Aged ; Retrospective Studies ; Spinal Nerves - drug effects ; Spinal Nerves - pathology ; Steroids ; Steroids - administration & dosage ; Treatment Outcome</subject><ispartof>Pain physician, 2015-03, Vol.18 (2), p.E177-E185</ispartof><rights>2015. This work is published under https://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25794217$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tak, Hyeong-Jun</creatorcontrib><creatorcontrib>Jones, Rodney</creatorcontrib><creatorcontrib>Cho, Yun-Woo</creatorcontrib><creatorcontrib>Kim, Eun-Hyuk</creatorcontrib><creatorcontrib>Ahn, Sang-Ho</creatorcontrib><title>Clinical evaluation of transforaminal epidural steroid injection in patients with gadolinium enhancing spinal nerves associated with disc herniation</title><title>Pain physician</title><addtitle>Pain Physician</addtitle><description>Transforaminal epidural steroid injection (TFESI) of corticosteroid is frequently employed to mitigate the painful and disabling symptoms of lumbar disc herniation. However, the treatment outcome of TFESI in patients with radicular pain and inflamed neural structures as assessed by contrast-enhanced magnetic resonance imaging (MRI) has not been forthcoming.
To investigate functional improvement and pain reduction following TFESI in patients found to have nerve inflammation as evidenced by gadolinium-enhanced (MRI).
Retrospective assessment.
Tertiary spinal intervention center, Daegu, Korea.
Thirty-seven patients were selected by strict inclusion criteria. Patients were classified into enhancing and non-enhancing groups as evidenced by gadolinium-enhanced MRI. The enhancing group was further divided into pre-dorsal roog ganglion (DRG) only enhanced group and pre-DRG and post-DRG enhanced group. Clinical outcomes were evidenced by numeric rating scale (NRS) and Oswestry disability index (ODI) at pretreatment, one week, and 4 weeks after treatment.
The improvement of NRS and ODI in the enhanced group was greater than those of the non-enhanced group, at one week and 4 weeks after TFESI (P < 0.05). However there was no significant difference in improvement of NRS and ODI between pre-DRG only enhanced group and pre-DRG and post-DRG enhanced group at one week and 4 weeks after TFESI.
Retrospective chart review with a small sample size.
The improvement of NRS and ODI in the enhanced group was significantly greater than those of the non-enhanced group after TFESI. Radicular pain and functional impairment in the presence of gadolinium enhancing spinal neural structures and lumbar disc herniation may be more responsive to TFESI than patients without enhancing neural structures.</description><subject>Adult</subject><subject>Epidural</subject><subject>Female</subject><subject>Gadolinium</subject><subject>Humans</subject><subject>Injections, Epidural - methods</subject><subject>Injections, Epidural - standards</subject><subject>Intervertebral Disc Displacement - diagnosis</subject><subject>Intervertebral Disc Displacement - drug therapy</subject><subject>Lumbar Vertebrae - pathology</subject><subject>Magnetic resonance imaging</subject><subject>Magnetic Resonance Imaging - methods</subject><subject>Magnetic Resonance Imaging - standards</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Retrospective Studies</subject><subject>Spinal Nerves - drug effects</subject><subject>Spinal Nerves - pathology</subject><subject>Steroids</subject><subject>Steroids - administration & dosage</subject><subject>Treatment Outcome</subject><issn>1533-3159</issn><issn>2150-1149</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNpdkctq3DAUhkVpSKZJHqCbIuimG090JEuylmVILxDoJnsh65LRYEuuZKf0PfrA8cykXXR1BOf7f474EHoPZMsEkeJumg53lADfQre9BynfoA0FThqAVr1FG-CMNQy4ukLvaj0QwoRS7BJdUS5VS0Fu0J_dEFO0ZsD-2QyLmWNOOAc8F5NqyMWMMR2XU3RLWR919iVHh2M6eHuCY8LTGvNprvhXnPf4ybh8LF1G7NPeJBvTE67TqSf58uwrNrVmG83s3TniYrV470uKpwNu0EUwQ_W3r_MaPX65f9x9ax5-fP2--_zQWEbbuQnKBukpsw5kDwL6wFxrBLchUCJJD8QQE6yXXS9UYEQy4Ty4jrSOg2_ZNfp0rp1K_rn4OutxvcMPg0k-L1WDELxVghG-oh__Qw95KeuPqqaCc6U6yuhKwZmyJddafNBTiaMpvzUQfTKmV2P6aExDp4_G1syH1-alH737l_iriL0A_QWWgg</recordid><startdate>20150301</startdate><enddate>20150301</enddate><creator>Tak, Hyeong-Jun</creator><creator>Jones, Rodney</creator><creator>Cho, Yun-Woo</creator><creator>Kim, Eun-Hyuk</creator><creator>Ahn, Sang-Ho</creator><general>American Society of Interventional Pain Physician</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>NAPCQ</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20150301</creationdate><title>Clinical evaluation of transforaminal epidural steroid injection in patients with gadolinium enhancing spinal nerves associated with disc herniation</title><author>Tak, Hyeong-Jun ; Jones, Rodney ; Cho, Yun-Woo ; Kim, Eun-Hyuk ; Ahn, Sang-Ho</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c324t-f9cf7e23cd17b161bf3d4a65cff2070b10a0afce78b69f30736de1d804d51e43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adult</topic><topic>Epidural</topic><topic>Female</topic><topic>Gadolinium</topic><topic>Humans</topic><topic>Injections, Epidural - methods</topic><topic>Injections, Epidural - standards</topic><topic>Intervertebral Disc Displacement - diagnosis</topic><topic>Intervertebral Disc Displacement - drug therapy</topic><topic>Lumbar Vertebrae - pathology</topic><topic>Magnetic resonance imaging</topic><topic>Magnetic Resonance Imaging - methods</topic><topic>Magnetic Resonance Imaging - standards</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Retrospective Studies</topic><topic>Spinal Nerves - drug effects</topic><topic>Spinal Nerves - pathology</topic><topic>Steroids</topic><topic>Steroids - administration & dosage</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tak, Hyeong-Jun</creatorcontrib><creatorcontrib>Jones, Rodney</creatorcontrib><creatorcontrib>Cho, Yun-Woo</creatorcontrib><creatorcontrib>Kim, Eun-Hyuk</creatorcontrib><creatorcontrib>Ahn, Sang-Ho</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Nursing & Allied Health Premium</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Pain physician</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tak, Hyeong-Jun</au><au>Jones, Rodney</au><au>Cho, Yun-Woo</au><au>Kim, Eun-Hyuk</au><au>Ahn, Sang-Ho</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical evaluation of transforaminal epidural steroid injection in patients with gadolinium enhancing spinal nerves associated with disc herniation</atitle><jtitle>Pain physician</jtitle><addtitle>Pain Physician</addtitle><date>2015-03-01</date><risdate>2015</risdate><volume>18</volume><issue>2</issue><spage>E177</spage><epage>E185</epage><pages>E177-E185</pages><issn>1533-3159</issn><eissn>2150-1149</eissn><abstract>Transforaminal epidural steroid injection (TFESI) of corticosteroid is frequently employed to mitigate the painful and disabling symptoms of lumbar disc herniation. However, the treatment outcome of TFESI in patients with radicular pain and inflamed neural structures as assessed by contrast-enhanced magnetic resonance imaging (MRI) has not been forthcoming.
To investigate functional improvement and pain reduction following TFESI in patients found to have nerve inflammation as evidenced by gadolinium-enhanced (MRI).
Retrospective assessment.
Tertiary spinal intervention center, Daegu, Korea.
Thirty-seven patients were selected by strict inclusion criteria. Patients were classified into enhancing and non-enhancing groups as evidenced by gadolinium-enhanced MRI. The enhancing group was further divided into pre-dorsal roog ganglion (DRG) only enhanced group and pre-DRG and post-DRG enhanced group. Clinical outcomes were evidenced by numeric rating scale (NRS) and Oswestry disability index (ODI) at pretreatment, one week, and 4 weeks after treatment.
The improvement of NRS and ODI in the enhanced group was greater than those of the non-enhanced group, at one week and 4 weeks after TFESI (P < 0.05). However there was no significant difference in improvement of NRS and ODI between pre-DRG only enhanced group and pre-DRG and post-DRG enhanced group at one week and 4 weeks after TFESI.
Retrospective chart review with a small sample size.
The improvement of NRS and ODI in the enhanced group was significantly greater than those of the non-enhanced group after TFESI. Radicular pain and functional impairment in the presence of gadolinium enhancing spinal neural structures and lumbar disc herniation may be more responsive to TFESI than patients without enhancing neural structures.</abstract><cop>United States</cop><pub>American Society of Interventional Pain Physician</pub><pmid>25794217</pmid><doi>10.36076/ppj/2015.18.E177</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Epidural Female Gadolinium Humans Injections, Epidural - methods Injections, Epidural - standards Intervertebral Disc Displacement - diagnosis Intervertebral Disc Displacement - drug therapy Lumbar Vertebrae - pathology Magnetic resonance imaging Magnetic Resonance Imaging - methods Magnetic Resonance Imaging - standards Male Middle Aged Retrospective Studies Spinal Nerves - drug effects Spinal Nerves - pathology Steroids Steroids - administration & dosage Treatment Outcome |
| title | Clinical evaluation of transforaminal epidural steroid injection in patients with gadolinium enhancing spinal nerves associated with disc herniation |
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