Efficacy of Transforaminal Epidural Steroid Injection with Local Anesthetic and Ozone Versus Transforaminal Epidural Steroid Injection with Local Anesthetic in Patients with Lumbar Radiculopathy

Authors

  • Tariq Mehmood Department of Anesthesia, Combined Military Hospital Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
  • Muhammad Rashid Iqbal Department of Anesthesia, Combined Military Hospital Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
  • Chaudhry Raheel Ranjha Department of Anesthesia, Combined Military Hospital Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
  • Mudassar Iqbal Department of Anesthesia, Combined Military Hospital Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
  • Aijaz Ali Department of Anesthesia, Combined Military Hospital Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
  • Ameer Yaseer Zaid Department of Anesthesia, Combined Military Hospital Rawalpindi/National University of Medical Sciences (NUMS) Pakistan

DOI:

https://doi.org/10.51253/pafmj.v74i6.10624

Keywords:

Epidural Steroid Injection, Low Back Pain, Ozone, Radiculopathy

Abstract

Objective: To compare the efficacy of Transforaminal Epidural Steroid Injection with local anesthetic versus Transforaminal Epidural Steroid Injection with local anesthetic and Ozone in patients with lumbar spine radiculopathy.

Study Design: Quasi-experimental study.

Place and Duration of Study: Pain Management Centre, Department of Anesthesia, Combined Military Hospital Rawalpindi, Pakistan from Oct 2022- Mar 2023.

Methodology: A total of 412 patients who underwent interventional procedures for radiculopathy were included in the study. These patients were divided into two equal groups, group-A (n=206) received Transforaminal Epidural Steroid Injection (40mg Triamcinolone) with local anesthetic (20mg Lignocaine) and Ozone (30 µg/ml) and group-B (n=206) received Transforaminal Epidural Steroid Injection (40mg Triamcinolone) with local anesthetic (20mg Lignocaine). The effects of both the regimens to treat pain in lower back were observed in the groups. Patients were assessed for pain using the visual analogue scale (VAS), for disability .....

Results: VAS at pre-procedure was 7.96 ± 0.587 and 8.15 ± 0.615 for group-A and B respectively (p= 0.005) and then at six months was 3.06 ± 0.898 for group-A and 3.45 ± 1.075 for group-B (p=0.001). Similarly, ODI at pre-procedure was 29.95 ± 4.032 and 30.06±3.761 for group-A and B respectively (p< 0.001) and then at six months was 13.83 ± 2.345 for group-A and 14.65± 2.336 for ....

Conclusion: Lumbar Radiculopathy treated with Transforaminal Epidural Steroid Injection with local anesthetic and Ozone has more patient satisfac......

 

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References

Ercalik T, Kilic M. Efficacy of Intradiscal Ozone Therapy with or without Periforaminal Steroid Injection on Lumbar Disc Herniation: A Double-Blinded Controlled Study. Pain Physician 2020; 23(5): 477-484.

https://doi.org/10.36076/PPJ.2020%2F23%2F477

Airaksinen O, Brox JI, Cedraschi C, Hildebrandt J, Klaber-Moffett J, Kovacs F, et al. European guidelines for the management of chronic nonspecific low back pain. Eur Spine J 2006;15 Suppl 2(Suppl 2): S192-300.

https://doi.org/10.1007/s00586-006-1072-1

Chemeisani A, Tarhini H, Haj Ali T, Jibbawi AA, Yehya K, Msheik A. The Benefit of Epidural Transforaminal Injection of Ozone in Comparison with Transforaminal Steroids Injection in the Management of Chronic Low Back Pain in Lebanese Population: One-Year Retrospective Study. Cureus 2023 23; 15(1): e34106. https://doi.org/10.7759/cureus.34106

Knezevic NN, Mandalia S, Raasch J, Knezevic I, Candido KD. Treatment of chronic low back pain – new approaches on the horizon. J Pain Res 2017; 10: 1111-1123.

https://doi.org/10.2147/jpr.s132769

Allegri M, Montella S, Salici F, Valente A, Marchesini M, Compagnone C, et al. Mechanisms of low back pain: a guide for diagnosis and therapy. F1000 Res 2016; 5: F1000 Faculty Rev-1530. https://doi.org/10.12688/f1000research.8105.2

Joel JJ, Dutta DE, Das GA, Kumar G.S, Panchal JA, Basak SA: Efficacy of Transforaminal Epidural Steroid Injection versus intraforaminal or periforaminal ozone for low back pain with radiculopathy. Indian J Pain 2015; 29(2): 64-72.

http://doi.org/10.4103/0970-5333.155172

Meucci RD, Fassa AG, Faria NM: Prevalence of chronic low back pain: systematic review. Rev Saude Publica 2015; 49: 1.

https://doi.org/10.1590/s0034-8910.2015049005874

Manchikanti L, Cash KA, Pampati V, Falco FJ. Transforaminal epidural injections in chronic lumbar disc herniation: A randomized, double-blind, active-control trial. Pain Physician 2014; 17: E489-501.

Spijker-Huiges A, Winters JC, van Wijhe M, Groenier K. Steroid injections added to the usual treatment of lumbar radicular syndrome: A pragmatic randomized controlled trial in general practice. BMC Musculoskelet Disord 2014; 15: 341. https://doi.org/10.1186/1471-2474-15-341

Jamadar NP, Ganesh K, Sandeep G, Joshi V, Vikram S. Efficacy of epidural Steroid injections in management of chronic low back pain. Indian J Basic Appl Med Res 2013; 2: 903-911.

Zhang Y, Ma Y, Jiang J, Ding T, Wang J. Treatment of the lumbar disc herniation with intradiscal and intraforaminal injection of oxygen-ozone. J Back Musculoskelet Rehabil 2013; 26: 317-322. https://doi.org/10.3233/bmr-130386

Masini M, Calaça A. Minimally invasive treatment for refractory low back pain, targeted by epidural endoscopy with O2/O3 and Steroid therapy. Acta Neurochir Suppl 2011; 108: 33-37. https://doi.org/10.1007/978-3-211-99370-5_6

Schoenfeld AJ, Weiner BK: Treatment of lumbar disc herniation: evidence-based practice. Int J Gen Med 2010, 3: 209-214. https://doi.org/10.2147/ijgm.s12270

Last AR, Hulbert K: Chronic low back pain: evaluation and management. Am Fam Physician 2009, 79: 1067-1074.

Muto M, Ambrosanio G, Guarnieri G, Capobianco E, Piccolo G,Annunziata G, et al. Low back pain and sciatica: Treatment with intradiscal-intraforaminal O (2)-O (3) injection. Our experience. Radiol Med 2008; 113: 695-706.

https://doi.org/10.1007/s11547-008-0302-5

Gallucci M, Limbucci N, Zugaro L, Barile A, Stavroulis E, Ricci A, et al. Sciatica: Treatment with intradiscal and intra foraminal injections of Steroid and oxygen ozone versus Steroid only. Radiology 2007; 242: 907-913.

https://doi.org/10.1148/radiol.2423051934

Fritz J, Niemeyer T, Clasen S, et al. Management of chronic low back pain: rationales, principles, and targets of imaging-guided spinal injections. Radiographics 2007, 27:1751-1771. https://doi.org/10.1148/rg.276065509

de Araújo LT, da Silva PC, Masini M. Medical Ozone as a Therapeutic Option in Musculoskeletal Pain Control: A Critical Review of Clinical Trials Considering Safety and Quality Indicators for Procedures and Devices. Yale J Biol Med 2024 30; 97(3): 383-398. https://doi.org/10.59249/hgtg9363

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Published

31-12-2024

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Original Articles

How to Cite

1.
Mehmood T, Iqbal MR, Ranjha CR, Iqbal M, Ali A, Zaid AY. Efficacy of Transforaminal Epidural Steroid Injection with Local Anesthetic and Ozone Versus Transforaminal Epidural Steroid Injection with Local Anesthetic in Patients with Lumbar Radiculopathy. Pak Armed Forces Med J [Internet]. 2024 Dec. 31 [cited 2025 Jan. 13];74(6):1609-13. Available from: https://pafmj.org/PAFMJ/article/view/10624