European Journal of Molecular & Clinical Medicine

Aims and objective: To compare efficacy of pain relief function of therapeutic transforaminal vs interlaminar epidural steroid injections and to assess improvement in functional outcome in lumbar disc disease patients after treatment.
Methodology: Patients with back pain documented with lumbar disc disease treated initially with rest, analgesics and physiotherapy for 6 weeks, will be analyzed clinically and radiologically. All the patients selected for the study be examined according to protocol, clinical and radiological investigations. Patients will be subjected into two groups by simple random sampling containing 30 members each. Group A will be given transforaminal epidural steroid injection and Group B will be given epidural steroid injection by Interlaminar route. Post epidural steroid injection  patients were followed up for 6months and post injection disability and pain was assessed using Roland morris low back pain disability questionnaire, visual numerical score, finger floor distance, patient satisfaction score.
Results: Pre procedure Roland Morris Disability mean score was compared with post epidural steroid injection. Reduction of 5 score or more after procedure considered significant. In a group receiving transforaminal epidural steroid, among 30 patients 24 patients had relief at end of 1month, 16 patients had relief at end of 6 months, and in other group receiving epidural steroid through interlaminar technique in that 12 patients had significant relief at 1 month, 8 patients had significant relief at the end of 6 months. On comparison of both the groups Roland morris disability mean score was statistically significance at 1month, 3 months and 6 months  in  TFESI group compared to ILESI group (p<0.05). On comparison of pre and post procedure Finger floor distance  of both the groups it was significant in TFESI group compared to ILESI group at 1 month and 3 months (p<0.05)  and was not significant at 6 months. Comparison by Patient satisfaction group was significant at 3 months in TFESI group compared to ILESI group (p<0.05)  and was not significant at 1month and 6 months. On comparison by Visual numerical score both the groups did not show any statistical significance.  Post procedure the complications, such as dural puncture, excessive bleeding or infection were not reported in both groups. But headache was reported in 2 patients in ILESI.
Conclusion: Patients with radicular pain from disc herniation or lumbar canal stenosis obtain significant relief from a TFESI. Transforaminal epidural steroid therapy has better outcome with respect to Roland Morris disability assessment, Visual Numeric Scale, Finger Floor Distance. Patient Satisfaction and Pain Relief - majority of the patients have a significant improvement which lasts for 6 months.