ArticleAsian spine journal2025
Clinical and radiographic predictive factors for the favorable outcome of lumbar epidural steroid injection in lumbosacral radiculopathy: a prospective analytical study from Thailand.
Article in Asian spine journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Dural Sac Cross-Sectional Area Measurement as an Indicator of Cauda Equina Syndrome Risk in Patients with Lumbar Disc Herniation.Journal of clinical medicine · 2026Article
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6 authors.
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Abstract
STUDY
designA prospective analytic study. PURPOSE: To investigate the clinical factors and magnetic resonance imaging (MRI) findings that can predict a favorable outcome following transforaminal epidural steroid injection (TFESI) in patients with lumbosacral radiculopathy. OVERVIEW OF LITERATURE: The efficacy of lumbar epidural steroid injection varies, and no clinical parameters have been established to predict a favorable response to TFESI reliably.
methodsIn total, 120 patients diagnosed with lumbosacral radiculopathy underwent TFESI. At each index spinal level, 5.0 mg of a dexamethasone mixture in 2.0% lidocaine and 0.5% bupivacaine was injected. At the 2-week follow-up, a favorable response to TFESI was defined as pain reduction upon movement of >50.0%. Pain manifestation and MRI findings were evaluated.
resultsA favorable response was observed in 60.8% of the patients 2 weeks post-TFESI. In the multivariate analysis, patients with mild central canal stenosis had 4.8 times higher odds of a favorable response to TFESI than those with severe central canal stenosis (adjusted odds ratio, 4.8; 95% confidence interval [CI], 1.2-18.8; p =0.023). Favorable responders experienced a notable 29-week period of pain reduction (95% CI, 10.3-47.8), along with a significantly lower incidence of surgery at 12 months (13.7%) (p <0.01). The mean pain score differences of 3.5 out of 10 observed 2 weeks and 1 month post-TFESI represented the optimal sensitivity and specificity in forecasting favorable responder status.
conclusionsA pain reduction of 3.5 out of 10 within 1 month is considered a clinical benchmark for predicting long-term positive outcomes after TFESI. The presence of severe central canal stenosis is significantly associated with an unfavorable response to TFESI.
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