title: The use of magnetic resonance imaging to predict the clinical outcome of non-surgical treatment for lumbar intervertebral disc herniation.
abstract: OBJECTIVE
  We wanted to investigate the relationship between the magnetic resonance (MR) findings and the clinical outcome after treatment with non-surgical transforaminal epidural steroid injections (ESI) for lumbar herniated intervertebral disc (HIVD) patients.
  
  
  METHODS
  Transforaminal ESI were performed in 91 patients (50 males and 41 females, age range: 13-78 yrs) because of lumbosacral HIVD from March 2001 to August 2002. Sixty eight patients whose MRIs and clinical follow-ups were available were included in this study. The medical charts were retrospectively reviewed and the patients were divided into two groups; the successful (responders, n = 41) and unsatisfactory (non-responders, n = 27) outcome groups. A successful outcome required a patient satisfaction score greater than two and a pain reduction score greater than 50%. The MR findings were retrospectively analyzed and compared between the two groups with regard to the type (protrusion, extrusion or sequestration), hydration (the T2 signal intensity), location (central, right/left central, subarticular, foraminal or extraforaminal), and size (volume) of the HIVD, the grade of nerve root compression (grade 1 abutment, 2 displacement and 3 entrapment), and an association with spinal stenosis.
  
  
  RESULTS
  There was no significant difference between the responders and non-responders in terms of the type, hydration and size of the HIVD, or an association with spinal stenosis (p > 0.05). However, the location of the HIVD and the grade of nerve root compression were different between the two groups (p < 0.05).
  
  
  CONCLUSIONS
  MRI could play an important role in predicting the clinical outcome of non-surgical transforaminal ESI treatment for patients with lumbar HIVD.
authors.affiliation: Department of Radiology, GangNeung Asan Hospital, University of Ulsan College of Medicine, GangNeung, Korea.
authors.forename: Soo-Jung
authors.initials: SJ
authors.lastname: Choi
authors.forename: Jae Seok
authors.initials: JS
authors.lastname: Song
authors.forename: Chunghwan
authors.initials: C
authors.lastname: Kim
authors.forename: Myung Jin
authors.initials: MJ
authors.lastname: Shin
authors.forename: Dae Sik
authors.initials: DS
authors.lastname: Ryu
authors.forename: Jae Hong
authors.initials: JH
authors.lastname: Ahn
authors.forename: Seung Moon
authors.initials: SM
authors.lastname: Jung
authors.forename: Man Soo
authors.initials: MS
authors.lastname: Park
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000188:drug therapy* / Q000473:pathology; D008159:Lumbar Vertebrae; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D013256:Steroids / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D013256:Steroids