• Seong-Sik Kang, Byeong-Mun Hwang, Hee-Jeong Son, Il-Young Cheong, Sang-Jin Lee, Sang-Hyun Lee, and Tae-Yoon Chung.
• Department of Anesthesiology and Pain Medicine, Institute of Medical Sciences, Kangwon National University Hospital, School of Medicine, Chuncheon, South Korea.
• Pain Physician. 2011 Jul 1;14(4):361-70.

BackgroundIntervertebral disc herniations are the most common cause of lumbosacral radiculopathy, and transforaminal epidural steroid injection (TFESI) is an important tool in treating lumbosacral radiculopathy. But the ideal dose of corticosteroid in the epidural management of lumbosacral radiculopathy has yet to be determined.ObjectiveThe aim of this study was to determine the effective dose of steroids in TFESI for pain reduction in patients with lumbosacral radiculopathy.Study DesignA randomized, double blind, controlled trial.SettingAn interventional pain management practice center.MethodsA total of 160 participants received 2 epidural injections of either 5 mg, 10 mg, 20 mg, or 40 mg of triamcinolone in one week intervals via TFESI. The degree of participant satisfaction and verbal numerical rating scale (VNRS) were assessed at pretreatment, one week, and 2 weeks after the first TFESI.ResultsThe number of participants experiencing pain relief was significantly less than in other groups in the 5 mg triamcinolone group at one week after the first TFESI. There were no significant differences among the groups at one week after the second TFESI. VNRS decreased in the other groups except the triamcinolone 5 mg group at one week after the first TFESI. VNRS decreased in all groups at one week after the second TFESI.LimitationsThe limitations include lack of placebo control group and lack of long-term follow-up.ConclusionsWe recommend a minimal effective dose of corticosteroid (triamcinolone 10 mg) in TFESI for patients with lumbosacral radiculopathy.

23 keywords...

hide…