COMPARISON OF ANALGESIC EFFICACY OF TRANSFORAMINAL VS CAUDAL EPIDURAL APPROACHES FOR UNILATERAL LUMBAR RADICULOPATHY
Keywords:Caudal epidural, Efficacy, Epidural, Radiculopathy, Sciatica
Objective: To compare the analgesic efficacy of transforaminal epidural vs. caudal epidural approaches for unilateral lumbar radiculopathy.
Study Design: Quasi experimental study.
Place and Duration of Study: Department of Pain Medicine, Combined Military Hospital (CMH) Rawalpindi, from Jul 2017 to Mar 2018.
Methodology: Total 96 patients of unilateral radiculopathy were randomly assigned into two equal groups. Group A (n=48) received transforaminal epidural injection of local anesthetic 2.5ml of 0.125% bupivacaine with steroid triamcinolone 40mg and group B received caudal epidural injection Local anesthetic 25ml of 0.125% bupivacaine with triamcinolone 40mg. Pain score was assessed at 0 (PRe procedural baseline), 4, and 12 weeks intervals after intervention by using numerical rating scale and values at 0 and 12 weeks compared for analysis.
Results: Mean numerical rating scale pain score in group A and group B were 7.5 ± 0.99 and 3.1 ± 1.6, 7 ± 1.10 and 5.55 ± 1.0 at 0 and 12 week respectively. There was a reduction in mean pain score from baseline to 12 week in both the groups with statistical significance more in group A compared to group B (p<0.05).
Conclusion: Pain relief score was found to be statistically significant in transforaminal epidural as compared to caudal epidural for unilateral radiculopathy at 12 weeks post procedure.