Comparing the Efficacy of Translaminar Epidural Steroid Injections Alone versus the Combination of Translaminar Epidural Steroid Injections with Selective Nerve Root Injections in Spinal Stenosis

Research Objectives: To evaluate and compare the outcomes of translaminar epidural steroid injections (TLESIs) alone versus the combination of selective nerve root injections (SNRIs) with TLESIs in the treatment of lumbosacral spinal stenosis.

Design: Parallel group RCT design.

Setting: Physical medicine and rehabilitation outpatient clinical setting.

Participants: The study was conducted on 42 patients (19 men, 23 women, with a mean age of 67.8 years) diagnosed with spinal stenosis, who showed symptoms of the condition and underwent magnetic resonance imaging and electromyography tests.

Interventions: The intervention groups were: TLESIs only and combined SNRIs with TLESIs. Both groups received treatment once a week for a total of three sessions.

Main Outcome Measures: The visual analogue scale and functional rating index were measured before injection, 1 week and 3 months after 3 times injection.

Results: The mean Visual Analog Scale scores before injection, one week after, and three months after three injections were 7.55, 3.22, and 3.61 for the TLESIs-only group, and 7.37, 2.06, and 2.31 for the group receiving both SNRIs and TLESIs. For the Functional Rating Index, the mean scores before injection, one week after, and three months after three injections were 25.16, 16.00, and 15.83 for the TLESIs-only group, and 22.50, 8.37, and 8.31 for the SNRIs with TLESIs group. The mean values for both VAS and FRI were significantly lower in the SNRIs with TLESIs group compared to the TLESIs-only group (p < 0.05).

Conclusions: The combination of SNRIs and translaminar epidural steroid injections TLESIs proved to be more effective in reducing pain and enhancing function compared to TLESIs alone in the treatment of lumbosacral spinal stenosis.

Author(s) Disclosures: All authors have no conflicts of interest to disclose.