Ann Rehabil Med.  2011 Aug;35(4):514-523. 10.5535/arm.2011.35.4.514.

Effects of Transforaminal Injection for Degenerative Lumbar Scoliosis Combined with Spinal Stenosis

• Nam HS
• Park YB

• KMID: 1971717
• DOI: http://doi.org/10.5535/arm.2011.35.4.514

Abstract

OBJECTIVE
The objectives of this study were to clarify the short-term effects of transforaminal epidural steroid injection (TFESI) for degenerative lumbar scoliosis combined with spinal stenosis (DLSS), and to extrapolate factors relating to the prognosis of treatment. METHOD: Thirty-six patients with lumbar radicular pain from DLSS were enrolled. Subjects were randomly assigned to one of two groups (steroid or lidocaine group). We compared the effect of pain suppression at 2, 4 and 12 weeks after the procedure between the two groups. Radiographic analysis included measurement of the Cobb's angle, the upper endplate obliquities of L3 and L4, and maximal lateral olisthy between two adjacent lumbar vertebrae. Sagittal plane measurement included lumbar lordosis, and thoracolumbar kyphosis. Statistical analysis of both radiographic and clinical parameters along with treatment outcome was performed to determine any significant correlations between the two.
RESULTS
There were no significant differences in the demographic data, initial visual analogue scale (VAS) or Oswestry disability index (ODI) between the steroid group (n=17) and the lidocaine group (n=19). Two, 4, and 12 weeks after injection VAS, ODI showed a significantly greater improvement in the steroid group compared to the lidocaine group (p<0.05). The radiographic and clinical parameters were not significantly correlated with treatment outcome.
CONCLUSION
Our findings suggest that fluoroscopic transforaminal epidural steroid injections appear to be an effective non-surgical treatment option for patients with degenerative lumbar scoliosis combined with spinal stenosis (DLSS) and radicular pain.

Keyword

Degenerative; Scoliosis; Steroid; Stenosis; Transforaminal

MeSH Terms

Animals
Constriction, Pathologic
Humans
Kyphosis
Lidocaine
Lordosis
Lumbar Vertebrae
Prognosis
Scoliosis
Spinal Stenosis
Treatment Outcome
Lidocaine

Figure

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  Fig. 1 Fluoroscopically guided transforaminal epidural injection. (A) anteroposterior view, (B) lateral view.

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  Fig. 2 Comparative response from VAS pre-injection, 2 weeks, 1 month, 3 months for steroid group and lidocaine group. *statistically significant at p<0.05 within groups, #statistically significant at p<0.05 within intergroup. VAS: Visual analogue scale, S: Steroid group, L: Lidocaine group.

• 

  Fig. 3 Comparative response from ODI pre-injection, 2 weeks, 1 month, 3 months for steroid group and lidocaine group. *statistically significant at p<0.05 within groups, #statistically significant at p<0.05 within intergroup. ODI: Oswestry disability index, S: Steroid group, L: Lidocaine group.

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