The Clinical outcomes of Selective Transforaminal Epidural Block in Patients with Degenerative Lumbar Spinal stenosis

Abstract

PURPOSE : Selective transforaminal epidural block (STEB) has shown effectiveness as therapeutic option for the management of patients with degenerative lumbar disease. But STEB in degenerative lumbar spinal stenosis was reported less effective than in herniated lumbar disc. This study was carried out in order to determine the outcomes associated with STEB in patients with degenerative lumbar spinal stenosis and to identify the short- and long-term therapeutic benefit.

MATERIALS AND METHODS : Sixty-seven patients were selected for participation in this study. Their diagnosis were based on the clinical symptoms and MRI findings. We performed STEB under fluoroscopic guidance and injected mixture of triamcinolone, mepivacaine and normal saline. We classified the patient outcomes as excellent, good, moderate or poor, according to the degree of reduction in VAS score from baseline. Improvement was evaluated with pre- and post-block visual analogue scale score and follow-up evaluation was performed at the time of first recurrence to the level of pre-block pain. The independent variables assessed included demographic data, symptom duration, number of blocks, primary diagnosis, medication of oral analgesics history, radiating pain, back surgery, frequency of STEB, standing/walking tolerance scale, and patient satisfaction scale at baseline, 1 month after their procedure.

RESULTS : Mean VAS score change was ? 4.8 and excellent results of 32(56%)patients, good of 13(23%), moderate of 7(12%), poor of 5(9%) were noted at 1 month after their procedure. We compared the initial standing and walking scores with the 1 month scores using an improvement of 67% and 71%.

CONCLUSION : Despite of relative short-term effect, STEB provides substantial pain relief in majority of patients and this lead early and efficient rehabilitation and exercise therapy. Especially, Selective transforaminal epidural block is effective in treating old age patient with or without medical problem. 발표분야 : 신경통증