title: Radicular pain in post lumbar surgery syndrome: the significance of transforaminal injection of steroids.
abstract: OBJECTIVE
  The objective of the study was to see if transforaminal injection of steroids might be an effective treatment for persistent radicular pain after disc surgery.
  
  
  METHODS
  The study was designed as a retrospective practice audit covering a time period of 2 years.
  
  
  METHODS
  The study was set in a single spine center in which all patients underwent lumbar disc surgery, postoperative follow-up, and subsequent treatment.
  
  
  METHODS
  Patients with postsurgical radicular pain were treated with a transforaminal injection of a steroid. The effect was evaluated in terms of pain reduction, duration of pain relief, and in relation to a recurrent disc herniation in postperative magnetic resonance imaging.
  
  
  RESULTS
  Of 479 patients who underwent microsurgical lumbar disc surgery, 69 had persistent radicular pain. Transforaminal injection of steroid achieved pain reduction of at least 50% in 26.8% of these patients. The success rate was higher (43%) in patients without a recurrent disc herniation.
  
  
  CONCLUSIONS
  Transforaminal injection of steroid appears to be effective in only a minority of patients with radicular pain persisting after disc surgery, but is more often effective in patients without recurrent disc herniation.
authors.affiliation: Department of Neurosurgery, Nova Clinic, Biberach, Germany. klessinger@nova-clinic.de
authors.forename: Stephan
authors.initials: S
authors.lastname: Klessinger
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002045:Bupivacaine / Q000008:administration & dosage / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007267:Injections; D055959:Intervertebral Disc Degeneration / Q000601:surgery*; D007405:Intervertebral Disc Displacement / Q000601:surgery*; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000188:drug therapy* / Q000209:etiology; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy* / Q000209:etiology; D011843:Radiculopathy / Q000188:drug therapy / Q000209:etiology; D012189:Retrospective Studies; D016896:Treatment Outcome; D014221:Triamcinolone / Q000008:administration & dosage / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D000779:Anesthetics, Local; D000893:Anti-Inflammatory Agents; D014221:Triamcinolone; D002045:Bupivacaine