Response predictors for lumbar epidural steroid injection outcomes for radiculopathy: a retrospective study
Source: PubMed Central Open Access, NCBI / U.S. National Library of Medicine
Supplemental Digital Content is Available in the Text. Clinical history and treatment context were more informative than MRI findings for estimating short-term lumbar ESI response. Prior spine surgery was associated with poorer response, whereas unilateral TFESI was associated with higher odds of short-term treatment success. toc Abstract Introduction: Epidural steroid injections (ESIs) are commonly used for lumbosacral radicular pain, but clinical outcomes remain variable. Objective: This study aimed to identify predictive factors and determine short-term patient-reported outcomes in an understudied Southeast Asian population. Methods: A retrospective study involving 198 patients with chronic lumbosacral radicular pain undergoing lumbar ESI was conducted. Treatment success was defined as a ≥30% reduction in the Brief Pain Inventory worst pain score at 4-week follow-up. At follow-up, 167 patients had complete data and were categorized as responders (n = 83) or nonresponders (n = 84). Multivariable binary logistic regression was performed using observed complete-case data to identify factors associated with treatment success. Results: The observed 4-week response rate was 49.7%. In multivariable analysis, previous spine surgery was associated with lower odds of treatment success (adjusted odds ratio [aOR] 0.30, 95% confidence interval [CI] 0.11–0.80,= 0.016), whereas unilateral transforaminal ESI (TFESI) was associated with higher odds of response compared with bilateral TFESI
Abstract
Supplemental Digital Content is Available in the Text. Clinical history and treatment context were more informative than MRI findings for estimating short-term lumbar ESI response. Prior spine surgery was associated with poorer response, whereas unilateral TFESI was associated with higher odds of short-term treatment success. toc Abstract Introduction: Epidural steroid injections (ESIs) are commonly used for lumbosacral radicular pain, but clinical outcomes remain variable. Objective: This study aimed to identify predictive factors and determine short-term patient-reported outcomes in an understudied Southeast Asian population. Methods: A retrospective study involving 198 patients with chronic lumbosacral radicular pain undergoing lumbar ESI was conducted. Treatment success was defined as a ≥30% reduction in the Brief Pain Inventory worst pain score at 4-week follow-up. At follow-up, 167 patients had complete data and were categorized as responders (n = 83) or nonresponders (n = 84). Multivariable binary logistic regression was performed using observed complete-case data to identify factors associated with treatment success. Results: The observed 4-week response rate was 49.7%. In multivariable analysis, previous spine surgery was associated with lower odds of treatment success (adjusted odds ratio [aOR] 0.30, 95% confidence interval [CI] 0.11–0.80,= 0.016), whereas unilateral transforaminal ESI (TFESI) was associated with higher odds of response compared with bilateral TFESI (aOR 3.16, 95% CI 1.23–8.13,= 0.017). Baseline current pain intensity showed a negative direction of association but did not reach statistical significance (aOR 0.86, 95% CI 0.73–1.02,= 0.086). Specific MRI findings were not significantly associated with clinical outcomes. Conclusion: Clinical history and treatment context were more informative than MRI findings for estimating short-term lumbar ESI response. Prior spine surgery was associated with poorer response, whereas unilateral TFESI was associated with higher odds of short-term treatment success.