title: Comparison of fluoroscopic Guided Transforaminal Epidural Injections of Steroid and Local Anaesthetic with Conservative Management in Patients with Chronic Lumbar Radiculopathies.
abstract: BACKGROUND
  Chronic lumbar radiculopathy is a common medical problem and the treatment modalities used over years have been many ranging from conservative or symptomatic management to open decompression surgery. This study was aimed at to compare two modalities of treatment, i.e., conservative and lumbar transforaminal epidural steroid injections (TFESIs).
  
  
  METHODS
  A total of 120 patients of American Society of Anesthesiology class - (a healthy patient or a patient with mild systemic disease) were randomized to two groups. Group C (n= 60) were managed conservatively with bed rest, analgesics, and physiotherapy. Group T (n= 60) received lumbar TFESIs with methylprednisolone 40 mg with 2 ml bupivacaine (0.5%). Measurements using visual analog scale (VAS) were taken before treatment and at various time intervals after the start of treatment.
  
  
  RESULTS
  There was no statistically significant difference regarding the demographic characteristics of both groups. The VAS scores were less and statistically significant in Group T after 30 min postinjection, at the 2ndweek and after 1 month. Recovery rate of straight leg raise test was found to be 98% in those treated with TFESI. The Group T had significantly better patient satisfaction score and additionally there was drug dose intake reduction before and after the treatment.
  
  
  CONCLUSIONS
  Patients treated with fluoroscopic-guided TFESI have better pain relief, quality-of-life, and less analgesic requirement than those managed conservatively.
authors.affiliation: Department of Anaesthesiology and Pain Management, Acharya Shri Chander College of Medical Sciences and Hospital, Jammu, Jammu and Kashmir, India.
authors.forename: Nandita
authors.initials: N
authors.lastname: Mehta
authors.affiliation: Department of Anaesthesiology and Pain Management, Acharya Shri Chander College of Medical Sciences and Hospital, Jammu, Jammu and Kashmir, India.
authors.forename: Misbah
authors.initials: M
authors.lastname: Salaria
authors.affiliation: Department of Orthopaedics, Acharya Shri Chander College of Medical Sciences and Hospital, Jammu, Jammu and Kashmir, India.
authors.forename: A Q
authors.initials: AQ
authors.lastname: Salaria
keywords: Conservative management; corticosteroids; local anesthetics; radiculopathy; transforaminal epidural steroid injection