J Korean Neurosurg Soc.  2024 Mar;67(2):194-201. 10.3340/jkns.2023.0002.

Guidance of Nerve Stimulator and Ultrasound for Transforaminal Epidural Steroid Injection in Lumbosacral Radicular Pain : A Single Institution Experience in Vietnam

• Le VT
• Nguyen CH
• Do PT
• Nguyen AM
• Vo KH

• KMID: 2553125
• DOI: http://doi.org/10.3340/jkns.2023.0002

Abstract

Objective
: This study aimed to evaluate the clinical feasibility of the combination of ultrasound and nerve stimulator guidance in transforaminal epidural steroid injections (TESIs) to manage lumbosacral chronic radicular pain.
Methods
: Using the combination of nerve stimulator and ultrasound guidance, TESIs were performed in 125 segments of 78 patients who presented with chronic lumbar radicular pain. Demographic characteristics and surgical outcomes were recorded on admission, pre-procedural and post-procedural for 1-week, 1-month, 3-month, and 6-month follow-ups. The result was measured using the Numeric rating scale (NRS) and Oswestry disability index (ODI).
Results
: Patients who received TESIs showed significant improvements on two evaluation tools (NRS, ODI), compared to that before procedure (p<0.001). No significant complications were observed for 6 months’ follow-up.
Conclusion
: The result suggests that a combination of ultrasound and nerve stimulator guidance in transforaminal epidural injections is safe, reliable and effective for short-term management of lumbar disc herniation. It is a promising technique and has shown good results in providing intermediate pain relief.

Keyword

Chronic pain; Injections; Ultrasound

Figure

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  Fig. 1. Ultrasound view in median sagittal plane.

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  Fig. 2. Ultrasound view in paramedian sagittal plane.

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  Fig. 3. “Crown sign” on axial plane. Arrows indicate ultrasound view in axial plane. SP : spinous process, AP : articular process, TP : transverse process, PC : posterior complex, AC : anterior complex.

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  Fig. 4. “In-plane” technique. SP : spinous process.

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  Fig. 5. Outcome measured by Numeric rating scale (NRS).

Reference

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