• Ekim Can Ozturk, Savas Sencan, Rekib Sacaklidir, Osman Albayrak, and Osman Hakan Gunduz.
• Marmara University, School of Medicine, Department of Physical Medicine and Rehabilitation, Pain Medicine Section, Istanbul, Turkey.
• Pain Physician. 2021 Aug 1; 24 (5): E619-E624.

BackgroundTransforaminal epidural steroid injection (TFESI) is an interventional technique used to relieve disc herniation related back and radicular pain. Although few studies have investigated the factors predicting positive outcomes after TFESI, there is no data concerning the possible relationship between pre-procedure serum 25-hydroxyvitamin D (25(OH)D) levels and the response to TFESI.ObjectivesTo investigate the effect of vitamin D deficiency to treatment success of fluoroscopy-guided transforaminal epidural steroid injection.Study DesignA retrospective assessment.SettingA university hospital interventional pain management center.MethodsNine hundred forty-eight patients received lumbosacral TFESI between January 2018 and December 2019 in a university hospital pain management center and were examined retrospectively for eligibility. Clinical and demographic data; magnetic resonance imaging (MRI); pre-procedure laboratory tests, including serum 25(OH)D; pain scores at baseline, third week, and third month follow-ups were collected.ResultsA total of 83 patients were recruited and divided into 2 groups with respect to vitamin D status. The number of patients with serum 25(OH)D level below 20 ng/mL was 57 and the number of patients with serum 25(OH)D level above 20 ng/mL was 26. Treatment success rates were significantly lower in vitamin D deficient group at third week and third month (P: 0.006, P: 0.01).LimitationsRetrospective nature and the absence of functional outcomes.ConclusionVitamin D deficiency is associated with a lower probability of meaningful pain relief following TFESI. It may worth assessing serum vitamin D level prior to this intervention, although prospective investigation is necessary.

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