Evaluating the Effectiveness of Transforaminal Epidural Steroid Injections for Lumbar Radiculopathy Due to a Herniated Nucleus Pulpous Utilizing PROMIS as an Outcome Measure.

Abstract

The purpose of this study was to evaluate the effect of transforaminal epidural steroid injection (TFESI) for patients with lumbosacral radiculopathy secondary to a lumbosacral herniated nucleus pulposus. A retrospective review of adult patients who received a fluoroscopically guided transforaminal epidural steroid injections for a herniated nucleus pulposus was performed. Patient-Reported Outcome Measurement Information System domains of physical function, pain interference, and depression were collected at baseline and postprocedure short-term (1-3 mos after procedure) and long-term follow-up (6-12 mos after procedure). Patient-Reported Outcome Measurement Information System physical function at short- and long-term follow-up statistically improved by 1.9 ( P = 0.02) and 4.6 ( P = 0.01) points, respectively. Patient-Reported Outcome Measurement Information System-pain interference at short- and long-term follow-up statistically improved by 3.7 ( P < 0.001) and 5.9 ( P = 0.002) points, respectively. Depression scores improved by 2.7 ( P = 0.04) at short-term follow-up, but long-term follow-up scores did not significantly differ from baseline scores. Ninety-one (85%) of patients did not elect for spine surgical consultation. Our study demonstrated that lumbosacral transforaminal epidural steroid injection was associated with a long-term improvement in function and pain for patients with lumbosacral radiculopathy due to a herniated nucleus pulposus as measured by Patient-Reported Outcome Measurement Information System-physical function and pain interference survey and obviated the need for spine surgery at long-term follow-up.