Evaluating the Effectiveness of Transforaminal Epidural Steroid Injections for Lumbar Radiculopathy Due to a Herniated Nucleus Pulpous Utilizing PROMIS as an Outcome Measure

Objective The purpose of this study was to evaluate the effect of transforaminal epidural steroid injection (TFESIs) for patients with lumbosacral radiculopathy secondary to a lumbosacral herniated nucleus pulposus (HNP). Design A retrospective review of adult patients who received a fluoroscopically guided TSNRI for a HNP was performed. Patient Reported Outcome Measurement Information System (PROMIS) domains of Physical Function (PF), Pain Interference (PI), and Depression (D) were collected at baseline and post-procedure short-term (1-3 months post-procedure) and long-term follow-up (6-12 months post-procedure). Results PROMIS PF at short- and long-term follow-up statistically improved by 1.9 (p = 0.02) and 4.6 (p = 0.01) points respectively. PROMIS PI at short- and long-term follow-up statistically improved by 3.7 (p < 0.001) and 5.9 (p - 0.002) points respectively. Depression scores improved by 2.7 (p = 0.04) at short-term follow-up but long-term follow-up scores did not significantly differ from baseline scores. 91 (85%) of patients did not elect for spine surgical consultation. Conclusions Our study demonstrated that lumbosacral TFESI was associated with a long-term improvement in function and pain for patients with lumbosacral radiculopathy due to a HNP as measured by PROMIS PF and PI survey and obviated the need for spine surgery at long-term follow-up.