title: Kambin triangle versus the supraneural approach for the treatment of lumbar radicular pain.
abstract: OBJECTIVE
  The aim of this study was to conduct a randomized, blinded, prospective outcome study on the short-term benefits of the Kambin triangle vs. the supraneural approach for the treatment of lumbar radicular pain.
  
  
  METHODS
  Subjects with lumbar radicular pain (n = 100) were randomly assigned to undergo transforaminal epidural steroid injection using either the Kambin triangle approach or the supraneural approach. Primary outcomes were measured with a verbal numeric pain scale and the Oswestry Disability Index, and the results at 2 and 12 wks after the procedure were compared between the groups. Secondary outcomes included patient satisfaction and the incidence of complications during the transforaminal epidural steroid injection procedure.
  
  
  RESULTS
  For both groups, the verbal numeric pain scale and Oswestry Disability Index scores improved 2 wks after the injections, and this improvement was maintained through the 12-wk follow-up. The verbal numeric pain scale, Oswestry Disability Index, and effectiveness scores were not significantly different between groups. Neural contact occurred in nine cases with the supraneural approach; no patients experienced neural contact with the Kambin triangle approach.
  
  
  CONCLUSIONS
  The Kambin triangle approach can be used instead of the supraneural approach in cases where it is difficult to place the needle at the anterior epidural space.
authors.affiliation: Department of Rehabilitation Medicine, Gachon University of Medicine and Science, Gil Medical Center, Incheon, Republic of Korea.
authors.forename: Ki Deok
authors.initials: KD
authors.lastname: Park
authors.forename: Jiwon
authors.initials: J
authors.lastname: Lee
authors.forename: Heami
authors.initials: H
authors.lastname: Jee
authors.forename: Yongbum
authors.initials: Y
authors.lastname: Park
mesh_terms: D000368:Aged; D015360:Analgesia, Epidural / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007268:Injections, Epidural / Q000379:methods*; D008012:Lidocaine / Q000008:administration & dosage*; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D011843:Radiculopathy / Q000188:drug therapy*; D016896:Treatment Outcome; D014221:Triamcinolone / Q000008:administration & dosage*
chemical_list: D000779:Anesthetics, Local; D000893:Anti-Inflammatory Agents; D014221:Triamcinolone; D008012:Lidocaine