title: The efficacy of lumbosacral transforaminal epidural steroid injections: a comprehensive literature review.
abstract: BACKGROUND
  There have been a number of recent studies showing the effectiveness of lumbosacral transforaminal steroid epidural injections used in the treatment of radicular pain. The studies include retrospective, prospective and randomized controlled studies. Thus, the data is valuable with regard to identifying evidence based recommendations that can be used for clinical practitioners.
  
  
  OBJECTIVE
  To review and critically evaluate literature focusing on the efficacy of lumbosacral transforaminal steroid injections. The goal of this review is to identify pertinent journal information that aids in the improvement of clinical care and guides future research by increasing the awareness of the efficacy of this procedure.
  
  
  METHODS
  A comprehensive literature review of the efficacy of lumbar sacral transforaminal epidural steroid injections.
  
  
  METHODS
  Medical databases were searched for key words of transforaminal lumbar sacral, anatomy, and efficacy of steroid injection using Pub Med, Medline, Cochrane databases and U.S. National Library of Medicine. Works cited lists were then searched and cross-referenced as well. Articles focusing solely on interlaminar and caudal steroid injections were excluded as were transforaminal studies focusing on the cervical spine. Also, articles were excluded that did not differentiate the type of technique with type of relief it produced. Papers focusing on the efficacy of lumbosacral transforaminal steroid injections were included in the data that followed the patient for three months or greater.
  
  
  RESULTS
  In all there were 10 randomized trials, 4 retrospective studies and 8 prospective studies found. Among the 10 randomized control studies only 8 met inclusion criteria. All 8 of the randomized control studies included show a positive outcome in both the short term and long term results. There were a total of 9 prospective trials showing a positive short term and long term outcome and that used both CT guided injections as well as fluoroscopic injections.
  
  
  CONCLUSIONS
  This systemic review included prospective, retrospective and randomized clinical trials showing that there was strong evidence for transforaminal injections in the treatment of lumbosacral radicular pain for both short term and long term relief.
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of Texas and Baylor College of Medicine, Houston, TX, USA.
authors.forename: Benoy
authors.initials: B
authors.lastname: Benny
authors.forename: Pari
authors.initials: P
authors.lastname: Azari
mesh_terms: D006801:Humans; D007268:Injections, Epidural; D008161:Lumbosacral Region; D011446:Prospective Studies; D011843:Radiculopathy / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D013256:Steroids / Q000008:administration & dosage* / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D013256:Steroids