Minimal differences in pain relief and function at 1 and 6 months were seen in a comparison of two commonly delivered epidural injection modalities, according to research presented at the 30th Annual Meeting of the American Academy of Pain Medicine. It was previously believed that transforaminal epidural steroid injections (TFESI) was superior to interlaminar epidural steroid injections (ILESI) because the medication was injected closer to the nerve entrapment site.
George Chang Chien, DO, from the Rehabilitation Institute of Chicago, IL, and authors conducted a systematic literature review for studies on relief and functional improvement to lower-back pain with TFESI and ILESI. Five prospective and 3 retrospective studies met the criteria, evaluating 506 patients total. While TFESI was superior to ILESI in pain relief by 15% at 2 weeks, at 1 or 6 months there was no difference between the two treatments for pain relief. When all 5 prospective studies were combined, the difference between the two treatments was not clinically significant (54.1% vs. 42.7% respectively).
For functional improvement at 2 weeks, ILESI was shown to be slightly superior (56.4%) compared to TFESI (49.4%) and only slight differences when the data was combined (40.1% for TFESI vs. 44.8% for ILESI).
Future research is necessary to confirm the results of this literature review, and the authors state that they plan to conduct such a study soon.
For more information visit the American Academy of Pain Medicine website.