title: Clinical effectiveness of single lumbar transforaminal epidural steroid injections.
abstract: OBJECTIVE
  To assess the clinical effectiveness of single lumbar transforaminal epidural steroid injections (TFESIs) in subjects with radicular pain with or without radiculopathy.
  
  
  METHODS
  Retrospective observational series.
  
  
  METHODS
  Single academic radiology pain management practice.
  
  
  METHODS
  Two thousand twenty-four subjects undergoing single lumbar TFESIs at the L4-5, L5-S1, or S1 neural foramina.
  Subjects were assessed with a pain numerical rating scale (NRS, 0-10) and Roland-Morris disability questionnaire (R-M, 23-point Deyo modification) prior to TFESI and at 2 weeks and 2 months follow-up. Successful pain relief (responders) was defined as either ≥50% reduction in NRS or pain 0/10; functional success was defined as ≥40% reduction in R-M score.
  
  
  RESULTS
  There were statistically significant (P < 0.0001) reductions in mean NRS and R-M scores at 2 weeks and 2 months postinjection. For NRS, 40.9% were responders at 2 weeks and 45.6% at 2 months. For R-M, 31.9% were responders at 2 weeks and 41.3% at 2 months. The proportion of responders for NRS and R-M was higher when there was <3 months of pain (odds ratio 2-month NRS = 2.42 [95% confidence interval: 1.82, 3.24], odds ratio 2-month R-M = 2.61 [1.96, 3.48]). For subjects with <3 months of pain, the proportion of responders was 62.4% (56.5, 68.3%) for NRS and 59.3% (53.3, 65.3%) for R-M scores.
  
  
  CONCLUSIONS
  This retrospective observational study suggests TFESIs are clinically effective in the treatment of lumbar radicular pain. Subjects with a shorter duration of pain are more likely to achieve a successful outcome.
authors.affiliation: Department of Radiology, Mayo Clinic, Rochester, Minnesota 55905, USA.
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Kaufmann
authors.forename: Jennifer R
authors.initials: JR
authors.lastname: Geske
authors.forename: Naveen S
authors.initials: NS
authors.lastname: Murthy
authors.forename: Kent R
authors.initials: KR
authors.lastname: Thielen
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Morris
authors.forename: John T
authors.initials: JT
authors.lastname: Wald
authors.forename: Felix E
authors.initials: FE
authors.lastname: Diehn
authors.forename: Kimberly K
authors.initials: KK
authors.lastname: Amrami
authors.forename: Rickey E
authors.initials: RE
authors.lastname: Carter
authors.forename: Randy A
authors.initials: RA
authors.lastname: Shelerud
authors.forename: Ralph E
authors.initials: RE
authors.lastname: Gay
authors.forename: Timothy P
authors.initials: TP
authors.lastname: Maus
mesh_terms: D000328:Adult; D000368:Aged; D001416:Back Pain / Q000188:drug therapy*; D015331:Cohort Studies; D016208:Databases, Factual; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007268:Injections, Epidural / Q000379:methods*; D016015:Logistic Models; D008159:Lumbar Vertebrae; D008161:Lumbosacral Region; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D012189:Retrospective Studies; D013256:Steroids / Q000008:administration & dosage* / Q000627:therapeutic use*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D013256:Steroids
keywords: Effectiveness; Epidural; Lumbar; Pain; Radicular; Spine; Steroid