A Systematic Review of the Effectiveness of CT-Guided, Lumbar Transforaminal Injection of Steroids
Article first published online: 23 SEP 2013
Wiley Periodicals, Inc
Volume 14, Issue 12, pages 1860–1865, December 2013
How to Cite
Bui, J. and Bogduk, N. (2013), A Systematic Review of the Effectiveness of CT-Guided, Lumbar Transforaminal Injection of Steroids. Pain Medicine, 14: 1860–1865. doi: 10.1111/pme.12243
- Issue published online: 11 DEC 2013
- Article first published online: 23 SEP 2013
- Radicular Pain;
- Computerized Tomography
To determine the effectiveness and safety of computerized tomography (CT) guided, lumbar transforaminal injection of steroids in the treatment of radicular pain.
Systematic review of published literature.
Two reviewers independently assessed 19 publications on the effectiveness and safety of CT-guided, lumbar transforaminal injection of steroids.
For effectiveness, the primary outcome was the success rate for relief of pain. For safety, the radiation exposure involved and the nature of complications were determined.
Much of the literature fails to provide evidence. Two studies reported decreases in mean or median pain scores but no other data. Two studies reported success rates of between 34% and 62% for achieving 50% relief of pain at between 1 and 6 months after treatment. CT-guided injections may involve greater radiation exposure than does fluoroscopy-guided injections and do not avoid catastrophic spinal cord injury.
The evidence-base for CT-guided lumbar transforaminal injection of steroids is meagre. This intervention is not more effective than fluoroscopy-guided injections and is not demonstrably safer.