Turkish Neurosurgery 2019 , Vol 29 , Num 2
Comparison of the Effect of Single Lumbar Transforaminal Epidural Steroid Injections for the Treatment of L4-5 and L5-S1 Paramedian Disc Herniation
Utku ADILAY1,Bulent GUCLU2,Levent DENIZ3,Ramazan KAHVECI1
1Balikesir University, School of Medicine, Department of Neurosurgery, Balikesir, Turkey
2Ministry of Health, Dr. Lutfi Kirdar Kartal Research and Training Hospital, Neurosurgery Clinic, Istanbul, Turkey
3Marmara Pain Center, Istanbul, Turkey
DOI : 10.5137/1019-5149.JTN.24029-18.1 AIM: To compare the outcomes of fluoroscopically guided transforaminal epidural steroid injections between L4-L5 paramedian disc herniation and L5-S1 paramedian disc herniation for the treatment of radicular pain.

MATERIAL and METHODS: A total of 593 patients treated by transforaminal epidural steroid injections for the treatment of L4-5 paramedian disc herniation and 504 patients treated by transforaminal epidural steroid injections for the treatment of L5-S1 paramedian disc herniation were included in the study. All the patients were regularly followed up for 12 weeks. Preprocedural Visual Analogue Scale (VAS) scores, 12-week post-procedural VAS scores and complications were recorded.

RESULTS: The mean preprocedural and postprocedural VAS scores for L4-5 paramedian disc herniation were 63.09 ± 5.37 and 15.81 ± 3.58, respectively, and the mean preprocedural and postprocedural VAS scores for L5-S1paramedian disc herniation were 61.15 ± 5.45 and 27.06 ± 3.62, respectively, for radicular pain. There was a statistically significant difference between preprocedural and postprocedural VAS scores for L4-5 and L5-S1 paramedian disc herniation (p<0.05). Transforaminal epidural steroid injections for L4-5 paramedian disc herniation were more effective than transforaminal epidural steroid injections for L5-S1 paramedian disc herniation.

CONCLUSION: This study showed that transforaminal epidural steroid injections for L4-5 paramedian disc herniation were more effective than transforaminal epidural steroid injections for L5-S1 paramedian disc herniation in the 12-week follow-up period. Keywords : Lumbar disc herniation, L4-L5, L5-S1, Paramedian disc herniation, Transforaminal epidural steroid injection

Corresponding author : Utku ADILAY, utkuadilay@hotmail.com