Abstract
Cortisone injection for radicular leg pain may be useful in treating patients with lumbar foraminal pathology based on accurate CT/MRI diagnosis and operator-controlled biplanar fluoroscopy in an angiography suite.
Patient details were collected from operative records and angiography suite records. Demographic data, diagnosis and level of injection were recorded. Low Back Outcome Scores (LBOS) were collected prospectively for most patients. Patients were then posted a questionnaire, including the LBOS. Patients were excluded from further analysis if further injection or surgery was required.
Fifty eight patients, all with CT or MRI diagnosis, underwent lumbar foraminal steroid injection. Thirty-seven had disc protrusion (64%) and twenty-one had stenosis (36%). Eighteen (31%) patients required further intervention, eleven with stenosis (52%) and seven with disc protrusion (19%). Thirty-two patients (80%) completed follow up questionnaires, one patient had died, one was lost to follow up, and six patients declined to complete the questionnaires. The average LBOS for the thirty-two patients who completed the questionnaires was 41.8+/−17.5. Twenty-three patients with pre-treatment LBOS improved on average from 25.1+/−13.5 to 45.9+/−16.1 following injection (p=0.050). Of this group, the eight patients with stenosis improved from 28.8+/−12.3 to 41.6+/−15.9 (average 12.9). The fifteen patients with disc protrusion improved from 23.2+/−14.1 to 48.1+16.3 (average 24.9). This difference in improvement between the two groups was significant (p=0.016).
This study reports 81% of patients with disc protrusions not requiring further treatment, with improvement of the average LBOS to 48.1=/−16.3. However the results in patients with foraminal stenosis was less satisfactory.
The abstracts were prepared by Editorial Secretary Jean-Claude Theis. Correspondence should be addressed to NZOA at Department of Orthopaedic Surgery, Dunedin Hospital, Private Bag 1921, Dunedin, New Zealand.
