Özet:

Objective: Lumbar disc herniation (LDH) is a common cause of low back pain and lumbar radiculopathy. In this study, the relationship between clinical results and pre-procedural magnetic resonance imaging (MRI) findings of patients with LDH-related radiculopathy symptoms who underwent lumbar transforaminal epidural steroid injection (TFESI) was evaluated. Materials and Methods: Between 2017 and 2021, 65 patients who were diagnosed as having LDH clinically and radiologically and underwent new MRI examination at the latest 3 months before the procedure were included in the study. In the operating room, under the scopy imaging, 1 cc opaque substance (iohexol) was diluted with 5 cc isotonic solution and 1.5-2 cc of this was injected into the area for confirmation in the scopy vision. Then 1 cc betamethasone and 4 cc 2% prilocaine hydrochloride were mixed, and 5 cc of this was injected. Pain scoring was evaluated with visual analog scale (VAS) and disability was evaluated with oswestry disability index (ODI). Pre-procedural MRIs were examined and grouped according to Michigan State University classification. Results: The patients’ median VAS and ODI scores were 8 [interquartile range (IQR): 7-8] and 74 (IQR: 67-77) before treatment; 2 (IQR: 1-3) and 14 (IQR: 10-29) in the 2nd week; and 2 (IQR: 1-4) and 16 (IQR: 4-40) in the 3rd month, respectively. It was determined that there was a statistically significant change in the pain and disability levels of the patients over time (ANOVA type test statistics=338,743, degree of freedom=1,542, p-value<0.001). It was determined that the change observed in VAS and ODI scores over time did not show a statistically significant difference according to disc type and location. Conclusion: The TFESI is a treatment method that can be used safely, independent of the disc type and localization in the MRI performed before the procedure.

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