EVALUATING THE USE OF TRANSFORAMINAL EPIDURALS IN THE TREATMENT PATHWAY OF LUMBAR RADICULAR PAIN. A REVIEW OF A SINGLE SURGEON'S PRACTICE OVER A 4 YEAR PERIOD

Background and AimsTransforaminal epidurals (TFEs) have been widely used as a treatment for lumbar radicular pain since its introduction by Krempen and Smith in 19741. Originally used as a diagnostic tool, it is now becoming increasingly recognised as a definitive treatment2. This study investigates the use of TFEs by a single surgeon over 4 years. We hoped that the study would add to our understanding and the discussion of the actual benefit of therapeutic steroid and local anaesthetic injections by this route3.Methods and ResultsA total of 181 patients were identified. At injection 10mls 0.25% Marcaine and 40mg Depomedrone was injected under fluoroscopic guidance. Clinic notes and MRI reports for all patients were reviewed.Of the 176 patients included in the study, 127 showed a symptomatic improvement. Of these patients, 59 proceeded to surgical decompression. For 50 patients, TFE was the definitive treatment. 13 patients were offered but declined surgery. 5 patients were too frail to proceed to surgery...