Comparison of outcome of the transforaminal vs interlaminar epidural steroids injection for patients with lumbosacral radicular pain: a meta-analysis

English Keywords:Transforaminal  Interlaminar  Ｅpidural steroids injection  Ｌumbosacral radicular pain  Ｍeta-anlysis

English Abstract:

  【Abstract】 Objectives: To assess the efficacy of lumbar transforaminal epidural steroids injection(TFESI) vs interlaminar epidural steroids injection(ILESI) for lumbosacral radiculopathy. Methods: The available literature of comparison between the transforaminal and interlaminar epidural steroids injection for low back and radicular pain was reviewed. Data sources included relevant literature of the English language identified in Pubmed, Medline, Embase and Ovid data bases from 1990 to 2014. The randomized controlled trials(RCT) were collected based on the strict criterion of inclusions and exclusions. The included articles were evaluated by using the Corchrane Handbook and the Revman 5.3 was used for meta-anlysis. Results: The initial research included 378 papers. After screening, 5 RCTs were recruited for analysis. According to the revised Jadad score, the score of 2 articles was 6, 2 was 7 and 1 was 5. Among the 199 patients, 102 undergoing TFESI and 97 undergoing ILESI were included. The meta analysis showed there was statistically significance between TFESI and ILESI at 2 weeks[MD=-1.77, 95%CI(-2.95, -0.59), P＜0.01], 1-3 months[MD=18.77, 95%CI([4.54, 33.0), P=0.01] and 6 months after injection[MD=-1.08, 95%CI(-1.53, -0.64), P＜0.05]. But the schober index(MD=0.07, 95%CI(-0.42, 0.57), P＞0.05) and finger-to-floor distance[MD=1.21, 95%CI(-6.41, 8.82), P＞0.05] showed no significant differences between the two groups at 1 month after injection. Conclusions: The TFESI has better outcome than ILESI in 6 months after injection for lumbosacral radicular pain, but no significant difference on the improvement of back stiffness at 1 month is noted.