• John Bui and Nikolai Bogduk.
• Department of Medical Imaging, John Hunter Hospital, Newcastle, New South Wales, Australia.
• Pain Med. 2013 Dec 1; 14 (12): 1860-5.

ObjectiveTo determine the effectiveness and safety of computerized tomography (CT) guided, lumbar transforaminal injection of steroids in the treatment of radicular pain.DesignSystematic review of published literature.InterventionsTwo reviewers independently assessed 19 publications on the effectiveness and safety of CT-guided, lumbar transforaminal injection of steroids.Outcome MeasuresFor effectiveness, the primary outcome was the success rate for relief of pain. For safety, the radiation exposure involved and the nature of complications were determined.ResultsMuch of the literature fails to provide evidence. Two studies reported decreases in mean or median pain scores but no other data. Two studies reported success rates of between 34% and 62% for achieving 50% relief of pain at between 1 and 6 months after treatment. CT-guided injections may involve greater radiation exposure than does fluoroscopy-guided injections and do not avoid catastrophic spinal cord injury.ConclusionThe evidence-base for CT-guided lumbar transforaminal injection of steroids is meagre. This intervention is not more effective than fluoroscopy-guided injections and is not demonstrably safer.Wiley Periodicals, Inc.

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