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Ann Rehabil Med. 2016 Dec;40(6):1071-1081. doi: 10.5535/arm.2016.40.6.1071. Epub 2016 Dec 30.

The Prognostic Value of Enhanced-MRI and Fluoroscopic Factors for Predicting the Effects of Transforaminal Steroid Injections on Lumbosacral Radiating Pain.

Author information

1
Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul, Korea.
2
Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul, Korea.
3
Department of Rehabilitation Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
4
Department of Rehabilitation Medicine, Daegu Fatima Hospital, Daegu, Korea.
5
Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul, Korea.; Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul, Korea.

Abstract

OBJECTIVE:

To investigate the predictive value of enhanced-magnetic resonance imaging (MRI) and fluoroscopic factors regarding the effects of transforaminal epidural steroid injections (TFESIs) in low back pain (LBP) patients with lumbosacral radiating pain.

METHODS:

A total of 51 patients who had LBP with radiating pain were recruited between January 2011 and December 2012. The patient data were classified into the two groups 'favorable group' and 'non-favorable group' after 2 weeks of follow-up results. The favorable group was defined as those with a 50%, or more, reduction of pain severity according to the visual analogue scale (VAS) for back or leg pain. The clinical and radiological data were collected for univariate and multivariate analyses to determine the predictors of the effectiveness of TFESIs between the two groups.

RESULTS:

According to the back or the leg favorable-VAS group, the univariate analysis revealed that the corticosteroid approach for the enhanced nerve root, the proportion of the proximal flow, and the contrast dispersion of epidurography are respectively statistically significant relative to the other factors. Lastly, the multiple logistic regression analysis showed a significant association between the corticosteroid approach and the enhanced nerve root in the favorable VAS group.

CONCLUSION:

Among the variables, MRI showed that the corticosteroid approach for the enhanced target root is the most important prognostic factor in the predicting of the clinical parameters of the favorable TFESIs group.

KEYWORDS:

Epidural injections; Intervertebral disc displacement; Low back pain; Magnetic resonance imaging

Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

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