ArticleInterventional pain medicine2024
Comparing the clinical outcomes of lumbar transforaminal vs interlaminar epidural steroid injections in a registry cohort.
Article in Interventional pain medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- The association between patient- and procedure-related factors and patient-reported intraprocedural pain during fluoroscopically guided lumbar epidural injections: A real-world cohort study.Interventional pain medicine · 2026Article
- The PLAN trial: precision treatment of lumbar spine surgery with advanced nerve root blockade - protocol for a prospective, investigator-initiated, randomized non-inferiority trial.BMC musculoskeletal disorders · 2025Article
- Practice Patterns of Physicians Who Perform Lumbar Transforaminal Epidural Steroid Injections.Current pain and headache reports · 2025Review
- The impact on fluoroscopic image review on perceived benefit, patient satisfaction, and short-term improvement following lumbosacral epidural steroid injections.Interventional pain medicine · 2025Article
- Modified transforaminal epidural steroid injection combined with pulsed radiofrequency: an effective treatment measure for lumbar radiculopathy.Frontiers in surgery · 2025Article
- Four-Week Outcomes of Transforaminal Epidural Injections in Patients With Lumbar Radicular Pain.Cureus · 2024Article
Corrections and comments
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Authors and funding
6 authors.
Funding
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Abstract
Background: Transforaminal and interlaminar approaches are both common means of performing epidural steroid injection. Comparative effectiveness data on outcomes of these approaches is available but has yielded mixed results. Objective: Compare the effect of transforaminal vs interlaminar delivery of epidural steroids on patient-reported pain severity. Design: Retrospective Cohort Study. Methods: A retrospective review of prospectively collected interventional spine procedure registry data between December 2011 and July 2017 from a single academic medical center. Those who received epidural steroid injections and had prospectively collected index pain data (11-point Numeric Rating Scale [NRS]) recorded in the patient's chart prior to the procedure and at a 3 month follow up appointment were included. The outcome of interest was ≥50% reduction in pain as measured using a NRS for back and/or leg pain. To evaluate true predictive odds of success, multivariable logistic regression modeling was used to determine the odds of achieving improved pain. Results: Of the 73 patients included in the study, 61 (84%) reported radicular pain, 49 (67%) reported back pain, and eleven (15%) had symptoms consistent with claudication, pain characteristics were not mutually exclusive. Fifty-one (70%) underwent transforaminal epidural steroid injection, while 22 (30%) underwent interlaminar injection. When claudication and radicular pain groups were combined into a single "leg pain" category (n = 66), 26/46 (57% 95% CI 41-71%) patients undergoing transforaminal and 6/20 (30% 95% CI 12-54%) patients undergoing interlaminar injections achieved ≥50% leg pain reduction on NRS (p = 0.048). Transforaminal epidural steroid injections were associated with higher odds of ≥50% reduction in leg pain in both the unadjusted model (OR 3.2, p = 00.034) and after adjustment for presence of radicular pain on presentation and the type of steroid used (OR 3.6, p = 0.042). Conclusion: In this clinical practice registry, patients treated with transforaminal epidural steroid injection were more likely to achieve ≥50% reduction in radicular or neurogenic/claudicatory leg pain compared to those treated with interlaminar epidural steroid injection.
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