Therapeutic trial of fluoroscopic interlaminar epidural steroid injection for axial low back pain: effectiveness and outcome predictors.
OBJECTIVE
An ESI for managing LBP is one of the most commonly performed interventions. The purpose of this observational study was to assess the effect of a therapeutic trial of a fluoroscopic interlaminar ESI for axial LBP and to analyze the outcome predictors.


METHODS
All patients who received an interlaminar ESI for axial LBP at our facility in 2007 and 2008 were included. Initial short-term follow-up was done at <1 month after ESI. ESI was considered effective if patients had a reduction of >50% in their pain scores. In July 2009, telephone interviews were conducted by using formatted questions including the NASS patient-satisfaction index. The symptom-free interval was computed by the Kaplan-Meier method. Outcome predictors such as age, sex, duration of LBP, and MR imaging findings were statistically analyzed by the Mann-Whitney U and the Fisher exact tests.


RESULTS
Eighty-one patients (male/female = 16:65; mean age, 49.9 years; range, 17-77 years) were included in the study. The interlaminar ESI was effective in 63 of the 81 patients (77.8%) at initial short-term follow-up. For the 63 patients in whom ESI was effective, the median symptom-free interval was 154 days (95% CI, 96-212 days). Among 68 patients for whom telephone interviews were possible, 44 patients (64.7%) replied positively to the NASS patient satisfaction index (NASS patient-satisfaction index, 1 or 2). There were no significant outcome predictors.


CONCLUSIONS
The therapeutic trial of a fluoroscopic interlaminar ESI was effective for axial LBP without significant outcome predictors.
Lee
J W
JW
Departments of Radiology, Seoul National University Bundang Hospital, Gyeongi-Do, Korea.
Shin
H I
HI
Park
S Y
SY
Lee
G Y
GY
Kang
H S
HS
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005471:Fluoroscopy / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D007268:Injections, Epidural / Q000379:methods*; D053208:Kaplan-Meier Estimate; D017116:Low Back Pain / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013256:Steroids / Q000008:administration & dosage*; D016896:Treatment Outcome; D055815:Young Adult
D013256:Steroids