Keywords : Lumbar
Clinical Effectiveness Of “Transforaminal Epidural Block”by Subpedicular Approach In Lumbar Radiculopathy
European Journal of Molecular & Clinical Medicine,
2020, Volume 7, Issue 6, Pages 963-971
Introduction :TFEB(Transforaminal Epidural Block) involves delivery of drugs through the epidural space and along the nerve root.’’This procedure can be both diagnostic (to know whether the given nerve root is the cause of pain) and therapeutic (to lessen pain by deceasing irritation around the nerve root) purposes’’. The subpedicular approach is a very commonly used procedure at present. This technique involves placement of the spinal needle in‘’the secure triangle under the inferior exterior of the pedicle to reach the superolateral spinal nerve responsible for pain generation’’.‘’Transforaminal area is the favoured location,as the drugs can be directly ‘’delivered into the anterior extradural space, i.e. area stuck between the back of the protruded disc and the anterior nerve root dural sleeve,thus reducing the risk of injuy to dura mater’’. Transforaminal Epidural Block injections reduces the inflammation andstabilizes the nociceptive neural activity thus relieving the pain.
Materials and methods :We conducted aProspective Cohort Study at IMS&SUM hospital,Bhubaneswar from Mach 2017 to December 2019.Our study includes 100 patients with lower back ache with radiculopathy due to disc herniation or lumbar canal stenosis managed conservatively for at least six weeks.All the patients have been diagnosed with transforaminal epidural block(TFEB). A complete clinical examination was done to rule out other causes of lowbachache with radiculopathy. Patient having predominant unilateral symptoms were given transforaminal block.
Results :. In our study 78 patients (78 %) had significant pain relief,which common in 48 patients(48%) till the go behind up period of more than 12 months,78 patients(78%)till the follow up period of 6months .The current study also provides evidence that, LTFEB provides significant respite of pain in majority of patients for three months following the block’’. Reduction in pain was assessed by‘’restoration of activities of daily life without the need for other treatment modalities’’.48% of patients who were administered LTFEB had relief that persists for more than 12 months, without need for any other treatment.
Conclusion : From our study we conclude that, LTFEBs are reliable and cost effective procedures, without major adverse effects. Irrespective of become old, gender, stage of injection, symptom period and harshness of pain, TFEBs can provide significant relief of pain in majority of patients.