The effectiveness of transforaminal epidural steroid injections on radicular pain, functionality, psychological status and sleep quality in patients with lumbar disc herniation

Article type: Research Article

Authors: Sariyildiz, Mustafa Akif^{a; *} | Batmaz, İbrahim^a | Yazmalar, Levent^a | Güneş, Mehmet^b | Turan, Yahya^c

Affiliations: [a] Department of Physical Medicine and Rehabilitation, Dicle University Faculty of Medicine, Diyarbakır, Turkey | [b] Department of Psychiatry, Dicle University Faculty of Medicine,Diyarbakır, Turkey | [c] Department of Neurosurgery, Dicle University Faculty of Medicine,Diyarbakır, Turkey

Correspondence: [*] Corresponding author: Mustafa Akif Sariyildiz, Department of Physical Medicine and Rehabilitation, Dicle University Faculty of Medicine, Diyarbakır, Turkey. Tel.: +90 505 7673521; Fax: +90 412 2488523; E-mail:[email protected]

Abstract: BACKGROUND: The significance of fluoroscopy-guided transforaminal epidural steroid injections (TFESI) in the treatment of lumbar disc herniation (LDH) is well known. The aim of our study is to investigate the effectiveness of TFESI on radicular pain, functionality, psychological status, and sleep quality in patients with LDH. METHODS: Seventy-five LDH patients (36 males, 39 females) were enrolled in the study. All patients received a fluoroscopically guided TFESI (betamethasone 40 mg, lidocaine 2%). Also all patients were evaluated according to (with the visual analogue scale) radicular pain, Oswestry disability index (ODI), hospital axiety and depression scale, and Pittsburgh sleep quality index (PSQI) at baseline, at two weeks, and 12 months post injections. RESULTS: Mean age was 46.4 ± 12.5. When compared to baseline measurements there were significant improvements in radicular pain, ODI, modified schober, Laseque angle, finger to floor distance, depressive symptoms and PSQI scores at two weeks and 12 months after injection. Improvement of at least 50% in radicular pain relief, ODI score and sleep quality index was detected at two weeks 83%, 71%, 69% respectively. This rate showed regression at 12 months of 73%, 65% and 62% respectively. Duration of symptoms was significantly negatively correlated with changes in scores of radicular pain, ODI, depressive symptoms, and PSQI. There were no significant correlations with symptom duration and anxious symptoms. CONCLUSION: Fluoroscopy guided TFESI had positive effects on radicular pain, functionality, depressive symptoms and sleep quality in management of LDH.

Keywords: TFESI, lumbar disc herniation, radicular pain, functionality, sleep quality, depressive symptoms

DOI: 10.3233/BMR-150438

Journal: Journal of Back and Musculoskeletal Rehabilitation, vol. 30, no. 2, pp. 265-270, 2017