Volume 25, Issue 117, November 2021

Comparison of pain score changes following CT- guided and fluoroscopy- guided epidural injection of methylprednisolone in patients with lumbar disc herniation

Robab Ghorban Pour^1,4♦, Shahrokh Yousefzadeh Chabok², Alireza Ghorbanpour³, Majid Pouremamali⁴

¹Department of Radiology, Poursina Hospital, Gilan University of MedicalSciences, Namjoo St, Rasht, Gilan, IR of Iran
²Department of Neurosurgery, Poursina Hospital, Gilan University of Medical Sciences, Namjoo St, Rasht, Gilan, IR of Iran
³Department of Surgery, Shahid Ansari Hospital, Gilan University of Medical Sciences, Shohada St, Rudsar, Gilan, IR of Iran
⁴Department of Radiology, Shahid Ansari Hospital, Gilan University of Medical Sciences, Shohada St, Rudsar, Gilan, IR of Iran

^♦Corresponding author
Department of Radiology, Shahid Ansari Hospital first floor, Shohada St, Rudsar, Gilan, Iran

ABSTRACT

Background: Imaging- guided ESI performed under the guide of fluoroscopy or CT- scan, is an effective non-surgical treatment for lumbar disk herniation. Theoretically, CT- scan is superior over fluoroscopy regarding its higher spatial resolution; however, it is not clear whether CT- guided ESIs yield better treatment outcomes. Purpose: We hypothesized that the choice of imaging guide impacts the treatment outcome after ESI. This study aimed to evaluate the influence of imaging guide on the treatment outcomes of ESI. Materials and Methods: This is a non-randomized interventional study involving 30 patients with clinical and MRI findings of lumbar disk herniation, half received CT- guided and the other half fluoroscopy-guided trans-foraminal epidural injections of methylprednisolone. Sampling method was convenient. Student t test and SPSS 10 statistical software were employed for statistical analysis. Results: The mean pain scores before and after ESI in CT- scan group were 7.06 ± 2.18 and 2.26 ± 1.79 compared to 7.06 ± 2.34 and 2.53 ± 2.03 in fluoroscopy group, respectively. The difference between mean pain scores in each group were statistically significant (P- value < 0.0001). The mean pain score differences between CT- scan group (4.80) and fluoroscopy group (4.53) were statistically non-significant (P- value = 0.643). Conclusion: Both CT- guided and fluoroscopy-guided ESIs significantly improved low back pain in patients with lumbar disk herniation; however, we observed no association between the treatment outcomes and the type of imaging modality at all evaluated time points of this study.

Keywords: Epidural steroid injection, Imaging- guided ESI, Lumbar disk herniation.

Medical Science, 2021, 25(117), 3024-3031

PDF