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Three-Month Outcomes Following Interlaminar Versus Transforaminal Epidural Steroid Injections for Lumbosacral Radiculopathy: A Single Center Retrospective Cohort Study

Austin R. Marcolina, DO (University of Texas Southwestern Medical School PM&R Program, Dallas, Texas); Denizen Kocak, MD; Cindy Tiu, DO; Kristen Hall; Kavita Trivedi, DO

Meeting: AAPM&R Annual Assembly 2020

Categories: Pain and Spine Medicine (2020)

Session Information

Session Title: Virtual Poster Hall

Session Time: None. Available on demand.

Disclosures: Austin R. Marcolina, DO: No financial relationships or conflicts of interest

Objective: Our aim was to evaluate the improvement in visual analog scale (VAS) from baseline to 3 months following interlaminar (ILESI) versus transforaminal (TFESI) approach epidural steroid injections as a measure of efficacy in the treatment of lumbosacral radiculopathy.

Design: Retrospective cohort Setting : Academic outpatient spine center Participants : A total of 380 patients that received a TFESI or ILESI between December 2016 and October 2019. 361 patients were in the TFESI grouping and 19 patients were in the ILESI grouping.

Interventions: Patients received a one-time TFESI or ILESI for previously diagnosed lumbosacral radiculopathy.

Main Outcome Measures: VAS score improvement from baseline to 3 months following ILESI vs. TFESI.

Results: Statistical analysis through a paired Student’s T-test identified that neither baseline nor 3-month mean VAS was statistically significant when comparing TFESI to ILESI. Of note, the demographic criteria for age, race, gender, and BMI were similar between the two groupings. The TFESI group was an average age of 65.3, BMI 29.7, 72.9% white, and 58.2% female. The ILESI group was an average age of 65.3, BMI 29.7, 72.9 % white, and 57.6% female. On average, the TFESI group improved from a baseline VAS of 6.1 (SD 2.6) to 3-month mean VAS 4.2 (SD 2.8), which was statistically significant (p < 0.0001). Similarly, the ILESI group improved from a baseline mean VAS 6.5 (SD 2.3) to 3-month mean VAS 4.4 (SD 3.0), though the change was not statistically significant (p=0.1908). Conclusions: When comparing patients with similar baseline VAS that received a one-time epidural steroid injection, there is no appreciable difference in VAS scores at 3 months for ILESI and TFESI. While TFESI did have a statistically significant change from baseline to 3-month VAS, ILESI did not meet statistical significance, likely due to the limited sample size. Both TFESI and ILESI are reasonable interventions in the management of lumbosacral radiculopathy.

Level of Evidence: Level III

To cite this abstract in AMA style:

Marcolina AR, Kocak D, Tiu C, Hall K, Trivedi K. Three-Month Outcomes Following Interlaminar Versus Transforaminal Epidural Steroid Injections for Lumbosacral Radiculopathy: A Single Center Retrospective Cohort Study [abstract]. PM R. 2020; 12(S1)(suppl 1). https://pmrjabstracts.org/abstract/three-month-outcomes-following-interlaminar-versus-transforaminal-epidural-steroid-injections-for-lumbosacral-radiculopathy-a-single-center-retrospective-cohort-study/. Accessed May 28, 2025.
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