Comparison of Epidural Steroid Injection between L5-S1 Retrodiscal Technique and S1 Transforaminal Technique in L5-S1 Spinal Stenosis with S1 Radicular Pain

Sithapan Munjupong, Nattaya Udomsakdi, Porameth Charoentanakorn, Wanwipha Malaithong, Nuj Tontisirin

Abstract


OBJECTIVE: To study the efficacy of L5-S1 retrodiscal technique compared to S1transforaminal technique in L5-S1 spinal stenosis with S1 radicular pain management.

MATERIALS AND METHODS: A randomized, double-blinded controlled trial wasconducted in 40 patients undergoing single-level lumbar epidural steroid injection underC-Arm fluoroscope. The tip of needle in retrodiscal group (R-group) was posterior toL5-S1 disc and the tip of needle in S1 transforaminal group (S-group) was in S1 foramen.All participants were followed up in 2 week, 2 and 3 months.

RESULTS: Twenty adults were enrolled and assigned in two groups equally. There wasno difference in demographic data. S-group had lower average VAS than R-group in 2and 3-month follow-up. Also, number of patients, who had at least 50% VAS reduction,was higher in S group in every follow-up. A comparison of the efficacy was defined byreducing 50 points of VAS (visual analog scale). p < 0.05 was considered as statisticallysignificant.

CONCLUSION: S1 transforaminal technique provided an advantage over L5-S1retrodiscal technique in reducing S1 radicular pain. (Clinicaltrials.in.th. number, TCTR20150127001 )

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