Comparison of Transforaminal Epidural Versus Intra-Articular Facet Joint Injection for Treatment of Lumbar Radiculopathy

Haroon  Tariq; Muhammad Rashid  Iqbal; Rao Ali Shan  Khan; Ameer Yasser  Zaid; Ali  Raza; Syed Aqib Ali  Shah

doi:10.51253/pafmj.v75i6.11226

Authors

Haroon Tariq 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
Rao Ali Shan Khan Department of Anesthesia, Combined Military Hospital Rawalpindi /National University of Medical Sciences (NUMS) Pakistan
Ameer Yasser Zaid Department of Anesthesia, Combined Military Hospital Rawalpindi /National University of Medical Sciences (NUMS) Pakistan
Ali Raza Department of Anesthesia, Combined Military Hospital Rawalpindi /National University of Medical Sciences (NUMS) Pakistan
Syed Aqib Ali Shah Department of Anesthesia, Combined Military Hospital Rawalpindi /National University of Medical Sciences (NUMS) Pakistan

DOI:

https://doi.org/10.51253/pafmj.v75i6.11226

Keywords:

Epidural, Facet, Intra-Articular, Lumbar, Radiculopathy

Abstract

Objective: To compare the analgesic efficacy of intra-articular facet joint block versus transforaminal epidural injection in patients with lumbar radiculopathy.

Study Design: Randomized controlled trial (IRCT trial id number 73631)

Place and Duration of Study: Anesthesia Department, Combined Military Hospital Rawalpindi, Pakistan, from Jun to Nov 2023.

Methodology: Patients were divided into two groups of 45 each, the facet-joint group (Group-A) and the epidural group (Group-B). Primary variables observed were median scores on standard visual analog scale (VAS), with 0 being no pain to 10 being excruciating pain, numeric rating scale (NRS), with 0 being no pain to 100 being excruciating pain and disability classification according to the Oswestry disability index (ODI).

Results: Median pain score on visual analog scale (VAS) was 3.00 (IQR=1.00) in Group-A versus 4.00 (IQR=0.00) in Group-B on follow-up after four weeks (p=0.002). The same assessment done after 3 months between both groups showed a median VAS score of 4.00 (IQR=0.00) in Group-A versus 4.00 (IQR=0.00) in Group-B (p=1.000). Assessment on the Oswestry disability index showed median scores of 15.00 (IQR=8.00) in Group-A versus 15.00 (IQR=10.00) in Group-B after 4 weeks. Similar assessment done at 3 months showed median score of 20.00 (IQR=20.00) in Group-A versus 25.00 (IQR=18.00) in Group-B (p=0.399).

Conclusion: We conclude that facet-joint injection provides adequate analgesia with better pain scores than transforaminal epidural injections for treatment of lumbar radiculopathy.

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Author Biography

Rao Ali Shan Khan, Department of Anesthesia, Combined Military Hospital Rawalpindi /National University of Medical Sciences (NUMS) Pakistan

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