Comparison of treatment outcomes in lumbar central stenosis patients treated with epidural steroid injections: interlaminar versus bilateral transforaminal approach

• Published in: The Korean journal of pain Vol. 33; no. 3; pp. 226 - 233
• Main Authors: Sencan, Savas, Edipoglu, Ipek Saadet, Celenlioglu, Alp Eren, Yolcu, Gunay, Gunduz, Osman Hakan
• Format: Journal Article
• Language: Korean
• Published: 대한통증학회 31-07-2020
• Subjects: Chronic Pain; Depression; Epidural; Injections; Low Back Pain; Lumbosacral Region; Neuralgia; Pain Management; Patient Outcome Assessment; Spinal Stenosis; Lumbosacral Region; Spinal Stenosis; Pain Management; Depression; Low Back Pain; Neuralgia; Patient Outcome Assessment; Injections, Epidural; Chronic Pain
• ISSN: 2005-9159; 2093-0569

Background: We aimed to compare interlaminar epidural steroid injections (ILESI) and bilateral transforaminal epidural steroid injections (TFESI) on pain intensity, functional status, depression, walking distance, and the neuropathic component in patients with lumbar central spinal stenosis (LCSS).
Methods: The patients were divided into either the ILESI or the bilateral TFESI groups. Prime outcome measures include the numerical rating scale (NRS), Oswestry disability index (ODI), Beck depression inventory (BDI), and pain-free walking distance. The douleur neuropathique en 4 questions score was used as a secondary outcome measure.
Results: A total of 72 patients were finally included. NRS, ODI, and BDI scores showed a significant decline in both groups in all follow-ups. Third-month NRS scores were significantly lower in the ILESI group (P = 0.047). The percentages of decrease in the ODI and BDI scores between the baseline and the third week and third month were significantly higher in the ILESI group (P = 0.017, P = 0.001 and P = 0.048, P = 0.030, respectively). Pain-free walking distance percentages from the baseline to the third week and third month were significantly higher in the ILESI group (P = 0.036, P < 0.001). The proportion of patients with neuropathic pain in the bilateral TFESI group significantly decreased in the third week compared to the baseline (P = 0.020).
Conclusions: Both ILESI and TFESI are reliable treatment options for LCSS. ILESI might be preferred because of easier application and more effectiveness. However, TFESI might be a better option in patients with more prominent neuropathic pain.