title: Comparison of transforaminal and interlaminar epidural steroid injections for the treatment of chronic lumbar pain.
abstract: METHODS
  A cross-sectional study.
  
  
  OBJECTIVE
  We compared the 12 month outcomes of fluoroscopically guided transforaminal epidural steroid injections with interlaminar epidural steroid injections for the treatment of chronic lumbar spinal pain. Chronic lower back pain is a multifactorial disorder with many possible etiologies. The lifetime prevalence of spinal pain is reportedly 65-80% in the neck and lower back. Epidural injection of corticosteroids is a commonly used intervention for managing chronic spinal pain.
  
  
  METHODS
  Patients who did not benefit from previous treatments were included in this study. Injections were performed according to magnetic resonance imaging findings at the nearest level of lumbar pathology; 173 patients received interlaminar epidural steroid injections and 126 patients received transforaminal epidural steroid injections. All of the patients were regularly followed up for 12 months using a verbal numeric rating scale. Magnetic resonance imaging findings, complications, verbal numeric rating scale, and satisfaction scores were recorded.
  
  
  RESULTS
  Lumbar disk pathology was the most frequently encountered problem. The interlaminar epidural steroid injections were preferred at the L4-L5 intervertebral level. Verbal numeric rating scale scores significantly decreased during the 12-month period compared to basal scores (p<0.001). Significant differences between the two groups according to verbal numeric rating scale and satisfaction scores were not observed (p>0.05). There were no major complications; however, the interlaminar epidural steroid injections group had 22 (12.7%) minor complications, and the transforaminal epidural steroid injections group had 12 (9.5%) minor complications.
  
  
  CONCLUSIONS
  This study showed that interlaminar epidural steroid injections can be as effective as transforaminal epidural steroid injections when performed at the nearest level of lumbar pathology using fluoroscopy in 12-month intervals.
authors.affiliation: Sakarya University Faculty of Medicine, Department of Anesthesiology and Pain Medicine, Sakarya, Turkey. Electronic address: sgbeyaz@gmail.com.
authors.forename: Serbülent Gökhan
authors.initials: SG
authors.lastname: Beyaz
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000008:administration & dosage*; D000704:Analysis of Variance; D059350:Chronic Pain / Q000188:drug therapy; D003430:Cross-Sectional Studies; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D007268:Injections, Epidural; D017116:Low Back Pain / Q000188:drug therapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D000700:Analgesics
keywords: Complication; Complicação; Dor lombar; Injeção espinhal; Interlaminar; Low back pain; Spinal injection; Transforaminal