Comparison of Epidural Steroid Injection between L5-S1 Retrodiscal Technique and S1 Transforaminal Technique in L5-S1 Spinal Stenosis with S1 Radicular Pain
สิทธาพันธ์ มั่นชูพงศ์*, Nattaya Udomsakdi, Porameth Charoentanakorn, วรรณวิภา มาลัยทอง, นุช ตันติศิรินทร์
Department of Anesthesiology, 315 Phramongkutklao Hospital, Ratchawithi Rd.,Ratchathewi District, Tungphrayathai, Bangkok 10400, Thailand; email:
OBJECTIVE: To study the efficacy of L5-S1 retrodiscal technique compared to S1
transforaminal technique in L5-S1 spinal stenosis with S1 radicular pain management.
MATERIALS AND METHODS: A randomized, double-blinded controlled trial was conducted in 40 patients undergoing single-level lumbar epidural steroid injection under C-Arm fluoroscope. The tip of needle in retrodiscal group (R-group) was posterior to L5-S1 disc and the tip of needle in S1 transforaminal group (S-group) was in S1 foramen.
All participants were followed up in 2 week, 2 and 3 months.
RESULTS: Twenty adults were enrolled and assigned in two groups equally. There was no difference in demographic data. S-group had lower average VAS than R-group in 2 and 3-month follow-up. Also, number of patients, who had at least 50% VAS reduction, was higher in S group in every follow-up. A comparison of the efficacy was defined by reducing 50 points of VAS (visual analog scale). p < 0.05 was considered as statistically significant.
CONCLUSION: S1 transforaminal technique provided an advantage over L5-S1
retrodiscal technique in reducing S1 radicular pain.
The Bangkok Medical Journal ปี 2560, February ปีที่: 13 ฉบับที่ 1 หน้า 31-36
Randomized controlled trial, epidural steroid injections, retrodiscal technique, S1 transforaminal technique, lumbosacral radicular pain