Abstract | OBJECTIVE: MATERIALS AND METHODS: Transforaminal epidural steroid injections were performed in 248 patients from June 2003 to May 2004. Fifty-six patients (33 women, 23 men; mean age, 53.3 years; age range, 30-83 years) were included. Therapeutic effects were evaluated 2 weeks after injection. The possible outcome predictors were as follows: intraepineural or extraepineural injection, saddle-type distribution pattern ( contrast material distributed rostrally to the epidural portion of the preganglionic nerve root) or not saddle type, cause of sciatica ( spinal stenosis vs herniated disk), patient age, patient sex, and duration of sciatica (acute or subacute [< 6 months] vs chronic [> 6 months]). The relationships between possible outcome predictors and therapeutic effects were analyzed. Statistical analysis was performed using Fisher's exact test, the chi-square test, and multiple logistic regression analysis. RESULTS: Forty-three (76.8%) of the 56 patients achieved a satisfactory result 2 weeks after transforaminal epidural steroid injection. Nineteen (65.5%) of the 29 patients treated by intraepineural injection and 24 (88.9%) of the 27 patients treated by extraepineural injection achieved a satisfactory result, and this difference was significantly different (p < 0.05). Other possible predictors of a better outcome were identified--that is, saddle-type pattern of contrast distribution, a herniated disk, and sciatica of less than 6 months' duration. Multiple regression analysis showed that the only factor significantly associated with outcome was the type of injection (p = 0.04, odds ratio: 5.01). CONCLUSION: Transforaminal epidural steroid is an effective tool for managing sciatica, and an extraepineural injection may be a predictor of a better outcome for sciatica treated using transforaminal epidural steroid.
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Authors | Joon Woo Lee, Sung Hyun Kim, In Sook Lee, Jung-Ah Choi, Ja-Young Choi, Sung Hwan Hong, Heung Sik Kang |
Journal | AJR. American journal of roentgenology
(AJR Am J Roentgenol)
Vol. 187
Issue 6
Pg. 1427-31
(Dec 2006)
ISSN: 1546-3141 [Electronic] United States |
PMID | 17114531
(Publication Type: Evaluation Study, Journal Article)
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Chemical References |
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Topics |
- Adult
- Aged
- Aged, 80 and over
- Contrast Media
(administration & dosage)
- Female
- Humans
- Injections, Epidural
- Male
- Middle Aged
- Radiography
- Retrospective Studies
- Sciatica
(diagnostic imaging, drug therapy)
- Steroids
(administration & dosage)
- Treatment Outcome
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