title: The 1-Year Results of Lumbar Transforaminal Epidural Steroid Injection in Patients with Chronic Unilateral Radicular Pain: The Relation to MRI Findings and Clinical Features.
abstract: OBJECTIVE
  In patients with chronic radicular pain, we aimed to evaluate subgroup differences in 1-yr response to transforaminal epidural steroid injection.
  
  
  METHODS
  In this longitudinal cohort study of 100 subjects, 170 transforaminal epidural steroid injections were performed for 1 yr. The sample was stratified by type of disc herniation (protrusion n = 57, extrusion n = 27), by location of disc herniation (central/subarticular n = 60, foraminal n = 24), by grade of nerve root compression (low-grade compression n = 61, high-grade subarticular nerve compression n = 14, high-grade foraminal nerve compression n = 25), and by positive Slump test (n = 67). Treatment response was evaluated by visual analogue scale leg pain and self-reported disability (Oswestry Disability Index). Logistic regression was used to analyze the predictive value of baseline characteristics including the stratified subgroups.
  
  
  RESULTS
  High-grade subarticular nerve compression predicted the 1-yr improvement in both visual analogue scale leg pain (P = 0.046) and Oswestry Disability Index (P = 0.027). Low age (P < 0.001), short duration of leg pain (P = 0.015), and central/subarticular disc herniation (P = 0.017) predicted improvement in Oswestry Disability Index.
  
  
  CONCLUSIONS
  In patients treated with one or several transforaminal epidural steroid injections due to chronic lumbar radicular pain, clinical findings failed to predict the 1-yr treatment response. Low age, short duration of leg pain, central/subarticular disc herniation, and high-grade subarticular nerve compression predicted a favorable 1-yr response to transforaminal epidural steroid injection.
authors.affiliation: From the Department of Orthopaedics, Clinical Sciences, Lund University, Lund, Sweden (HE, BJ, RBF); and Department of Radiology, Skåne University Hospital, Lund, Sweden (MA).
authors.forename: Harald
authors.initials: H
authors.lastname: Ekedahl
authors.forename: Bo
authors.initials: B
authors.lastname: Jönsson
authors.forename: Mårten
authors.initials: M
authors.lastname: Annertz
authors.forename: Richard B
authors.initials: RB
authors.lastname: Frobell
mesh_terms: D000367:Age Factors; D059350:Chronic Pain / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology; D015331:Cohort Studies; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007268:Injections, Epidural; D007405:Intervertebral Disc Displacement / Q000150:complications; D016015:Logistic Models; D008137:Longitudinal Studies; D017116:Low Back Pain / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology; D008159:Lumbar Vertebrae; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011237:Predictive Value of Tests; D011843:Radiculopathy / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology; D013256:Steroids / Q000008:administration & dosage*; D013548:Sweden; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D013256:Steroids