Caudal epidural steroid injection versus transforaminal ESI for unilateral S1 radiculopathy: a prospective, randomized trial.
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2023;11(24):12 Pain Med . 2023 Aug 1;24(8):957-962.What this means for my practice?
Overall, the CESI group provided similar clinical effectiveness to TFESI but required less procedural time and resulted in a lower radiation dose. The results of this trial were limited by a small sample size and short follow-up. Additionally, assessing the contrast spread would have confirmed and strengthened the results. Future larger trials are needed with longer follow-ups and more pain assessments, to confirm the results of this study.
Study Summary
62 patients with L5-S1 paracentral disc herniation causing unilateral S1 radicular pain were randomized to receive either a caudal epidural steroid injection (caudal ESI; n=31) or a transforaminal epidural steroid injection (S1 TFESI; n=31). Outcomes of interest included procedural time, radiation dose, pain on a Numeric Rating Scale (NRS), Oswestry Disability Index (ODI), and the incidence of ≥50% improvement in NRS. Procedure time and radiation dose were significantly lower in the caudal ESI group, whereas all other outcomes were similar between the two groups.
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