Predictive factors for treatment success of transforaminal epidural steroid injection in lumbar disc herniation-induced sciatica

Abstract

Background/aim: The aim of this study was to identify predictive factors for treatment success in transforaminal epidural steroidinjection in patients with lumbar disc herniation-induced sciatica.Materials and methods: A total of 219 patients who were diagnosed with unilateral sciatica and underwent transforaminal epiduralsteroid injections at the level of L4-5, L5-S1, or S1 neural foramina between March 2016 and May 2018 were retrospectively analyzed.The presence of transitional vertebrae and the grade of nerve root compression were evaluated by a radiologist. Data including age, sex,body mass index, duration of symptoms, injection levels, and pain scores were recorded. Pain scores were evaluated using the numericalrating scale. Treatment success was defined as a ≥50% decrease in pain scores at 3 months.Results: The study included 118 female and 101 male patients with a mean age of 43.65 ± 12.18 years. The mean duration of symptomswas 25.64 ± 2.17 weeks. Although the duration of symptoms was longer in patients for whom treatment failed, it did not reach statisticalsignificance. Decreased pain scores at 1 h had a significant effect on treatment success (p = 0.012, odds ratio (OR): 1.015, 95% confidenceinterval (CI), 1.003–1.026).Conclusions: Our study results suggest that a decreased pain score at 1 h is a predictor for a favorable three-month response totransforaminal epidural steroid injection in patients with lumbar disc herniation-induced sciatica.