title: A systematic review of the effectiveness of CT-guided, lumbar transforaminal injection of steroids.
abstract: OBJECTIVE
  To determine the effectiveness and safety of computerized tomography (CT) guided, lumbar transforaminal injection of steroids in the treatment of radicular pain.
  
  
  METHODS
  Systematic review of published literature.
  
  
  METHODS
  Two reviewers independently assessed 19 publications on the effectiveness and safety of CT-guided, lumbar transforaminal injection of steroids.
  
  
  METHODS
  For effectiveness, the primary outcome was the success rate for relief of pain. For safety, the radiation exposure involved and the nature of complications were determined.
  
  
  RESULTS
  Much of the literature fails to provide evidence. Two studies reported decreases in mean or median pain scores but no other data. Two studies reported success rates of between 34% and 62% for achieving 50% relief of pain at between 1 and 6 months after treatment. CT-guided injections may involve greater radiation exposure than does fluoroscopy-guided injections and do not avoid catastrophic spinal cord injury.
  
  
  CONCLUSIONS
  The evidence-base for CT-guided lumbar transforaminal injection of steroids is meagre. This intervention is not more effective than fluoroscopy-guided injections and is not demonstrably safer.
authors: Department of Medical Imaging, John Hunter Hospital, Newcastle, New South Wales, Australia.
authors: John
authors: J
authors: Bui
authors: Nikolai
authors: N
authors: Bogduk
mesh_terms: D006801:Humans; D007268:Injections, Epidural / Q000379:methods*; D008161:Lumbosacral Region; D011843:Radiculopathy / Q000188:drug therapy; D013256:Steroids / Q000008:administration & dosage*; D025321:Surgery, Computer-Assisted; D014057:Tomography, X-Ray Computed
chemical_list: D013256:Steroids
keywords: CT; Computerized Tomography; Injection; Lumbar; Radicular Pain; Steroids; Transforaminal