Evaluation of the effectiveness of therapeutic lumbar transforaminal epidural steroid injection application: Retrospective study

Objective: The aim of this study is to evaluate the effectiveness of lumbar interlaminar epidural steroid injections and to determine the suitability of this treatment option for patients with back pain. In this regard, our study has focused on pain scores before and after epidural steroid injections and tried to determine the treatment effectiveness. Method: This study was conducted after obtaining permission from the Non-Interventional Studies Ethics Committee of Dicle University Medical Faculty. At Dicle University Hospital's operating room, between 01.01.2019-01.01.2021, interlaminar lumbar steroid injections planned under elective conditions were evaluated with visual analogue scale (VAS) pain scores before and after the procedure for patients over 18 years of age. Results: A total of 232 patients, 59% of whom (n=136) were female and 41% (n=96) were male, were included in our study. A female:male ratio of 3:2 was found. The average age of the patients included in our study was found to be 47.39±13.5 (range: 19-84). Any chronic additional disease was found in 35% of the patients (n=82). It was found that the pre-procedure VAS score results and post-procedure VAS score results of the patients did not show normal distribution. The average pre-procedure VAS score of the patients was 8.39±1.29 (range: 6-10; median 8.50), while the average post-procedure VAS score was 3.48±0.677 (range: 2-4; median 4). It was found that the VAS pain score of the patients significantly decreased after the procedure (p=0.000). The procedure was considered successful in patients with a reduction in VAS score of more than 50%. Accordingly, the success rate in our study was recorded as 90% (209/232). No significant difference was found between pre-procedure and post-procedure VAS scores in terms of gender (p>0.05). No significant difference was found between pre-procedure and post-procedure VAS scores in terms of the presence of chronic disease (p>0.05). No correlation was found between the ages of the patients and VAS scores (p>0.05). A weak positive correlation was found between the pre-procedure VAS scores of the patients and the post-procedure VAS scores (p=0.041, r=0.134). In our study, a correlation was found in the pre-procedure and post-procedure VAS score. From the patient data we obtained in our model, we can predict the post-procedure VAS scores from the pre-procedure VAS scores. Accordingly, we can calculate the patient's post-procedure score with the formula post-procedure predicted VAS score= (26.4+pre-procedure score) / 10. Conclusions: This study demonstrates that lumbar interlaminar epidural steroid injections are an effective method for managing back pain. This treatment can be appliedton a wide patient population and significantly reduce pain scores. Furthermore, our development of a formula to predict post-procedure VAS scores from pre-procedure VAS scores could be an important tool in the clinical decision-making process. However, it should be remembered that this formula does not guarantee exact results for every patient, and each patient's individual situation should be considered.