title: Clinical evaluation of transforaminal epidural steroid injection in patients with gadolinium enhancing spinal nerves associated with disc herniation.
abstract: BACKGROUND
  Transforaminal epidural steroid injection (TFESI) of corticosteroid is frequently employed to mitigate the painful and disabling symptoms of lumbar disc herniation. However, the treatment outcome of TFESI in patients with radicular pain and inflamed neural structures as assessed by contrast-enhanced magnetic resonance imaging (MRI) has not been forthcoming.
  
  
  OBJECTIVE
  To investigate functional improvement and pain reduction following TFESI in patients found to have nerve inflammation as evidenced by gadolinium-enhanced (MRI).
  
  
  METHODS
  Retrospective assessment.
  
  
  METHODS
  Tertiary spinal intervention center, Daegu, Korea.
  
  
  METHODS
  Thirty-seven patients were selected by strict inclusion criteria. Patients were classified into enhancing and non-enhancing groups as evidenced by gadolinium-enhanced MRI. The enhancing group was further divided into pre-dorsal roog ganglion (DRG) only enhanced group and pre-DRG and post-DRG enhanced group. Clinical outcomes were evidenced by numeric rating scale (NRS) and Oswestry disability index (ODI) at pretreatment, one week, and 4 weeks after treatment.
  
  
  RESULTS
  The improvement of NRS and ODI in the enhanced group was greater than those of the non-enhanced group, at one week and 4 weeks after TFESI (P < 0.05). However there was no significant difference in improvement of NRS and ODI between pre-DRG only enhanced group and pre-DRG and post-DRG enhanced group at one week and 4 weeks after TFESI.
  
  
  CONCLUSIONS
  Retrospective chart review with a small sample size.
  
  
  CONCLUSIONS
  The improvement of NRS and ODI in the enhanced group was significantly greater than those of the non-enhanced group after TFESI. Radicular pain and functional impairment in the presence of gadolinium enhancing spinal neural structures and lumbar disc herniation may be more responsive to TFESI than patients without enhancing neural structures.
authors: Hyeong-Jun
authors: HJ
authors: Tak
authors: Rodney
authors: R
authors: Jones
authors: Yun-Woo
authors: YW
authors: Cho
authors: Eun-Hyuk
authors: EH
authors: Kim
authors: Department of Rehabilitation Medicine & Spine Center, Yeungnam University College of Medicine, Daegu, Korea, 2Department of Anesthesia, University of Kansas School of Medicine, Wichita, KS.
authors: Sang-Ho
authors: SH
authors: Ahn
mesh_terms: D000328:Adult; D005260:Female; D005682:Gadolinium; D006801:Humans; D007268:Injections, Epidural / Q000379:methods / Q000592:standards; D007405:Intervertebral Disc Displacement / Q000175:diagnosis* / Q000188:drug therapy*; D008159:Lumbar Vertebrae / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods / Q000592:standards; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013127:Spinal Nerves / Q000187:drug effects / Q000473:pathology*; D013256:Steroids / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D013256:Steroids; D005682:Gadolinium