Preview

"Хирургия позвоночника"

Расширенный поиск

Лечебно-диагностическая ценность трансфораминальных эпидуральных блокад у пациентов с грыжами межпозвонкового диска и корешковой болью: аналитический обзор литературы

https://doi.org/10.14531/ss2020.3.53-65

Полный текст:

Аннотация

Цель исследования – анализ информации об использовании эпидуральных инъекций в лечении и диагностике пациентов с грыжами межпозвонковых дисков. Освещены эпидемиология и современные представления о патогенезе формирования болевого синдрома у пациентов с грыжами межпозвонковых дисков, алгоритмах и методиках консервативного и хирургического лечения таких пациентов. Представлена информация о способах и особенностях различных путей эпидуральных инъекций, используемых при этом лекарственных препаратах, а также проведена сравнительная оценка их эффективности и безопасности. Отдельно обсуждается диагностическая и прогностическая значимость трансфораминальной эпидуральной блокады.

Об авторах

А. Л. Кривошапкин
Новосибирский государственный медицинский университет; Европейский медицинский центр
Россия

Алексей Леонидович Кривошапкин, д-р мед. наук, проф.

630091, Новосибирск, ул. Красный проспект, 52;

129090, Москва, ул. Щепкина, 35



И. Д. Савицкий
Новосибирский государственный медицинский университет; Европейский медицинский центр
Россия

Игорь Дмитриевич Савицкий, врач-нейрохирург

630091, Новосибирск, ул. Красный проспект, 52;

129090, Москва, ул. Щепкина, 35



Г. С. Сергеев
Европейский медицинский центр
Россия

Глеб Сергеевич Сергеев, канд. мед. наук

129090, Москва, ул. Щепкина, 35



А. С. Гайтан
Новосибирский государственный медицинский университет; Европейский медицинский центр
Россия

Алексей Сергеевич Гайтан, врач-нейрохирург, канд. мед. наук

630091, Новосибирск, ул. Красный проспект, 52;

129090, Москва, ул. Щепкина, 35



О. А. Абдуллаев
Новосибирский государственный медицинский университет; Европейский медицинский центр
Россия

Орхан Альзамин оглы Абдуллаев, врач-нейрохирург, аспирант кафедры нейрохирургии

630091, Новосибирск, ул. Красный проспект, 52;

129090, Москва, ул. Щепкина, 35



Список литературы

1. Wang YX, Wang JQ, Kaplar Z. Increased low back pain prevalence in females than in males after menopause age: evidences based on synthetic literature review. Quant Imaging Med Surg. 2016;6:199–206. DOI: 10.21037/qims.2016.04.06.

2. Waterman BR, Belmont PJ Jr, Schoenfeld AJ. Low back pain in the United States: incidence and risk factors for presentation in the emergency setting. Spine J. 2012;12:63–67. DOI: 10.1016/j.spinee.2011.09.002.

3. Rasmussen-Barr E, Held U, Grooten WJ, Roelofs PD, Koes BW, van Tulder MW, Wertli MM. Nonsteroidal anti-inflammatory drugs for sciatica. Spine. 2017;42:586–594. DOI: 10.1097/BRS.0000000000002092.

4. Kim YK, Kang D, Lee I, Kim SY. Differences in the incidence of symptomatic cervical and lumbar disc herniation according to age, sex and national health insurance eligibility: a pilot study on the disease’s association with work. Int J Environ Res Public Health, 2018;15:2094. DOI: 10.3390/ijerph15102094.

5. Koes BW, van Tulder MW, Peul WC. Diagnosis and treatment of sciatica. BMJ. 2007;334:1313–1317. DOI: 10.1136/bmj.39223.428495.BE.

6. Frymoyer JW. Lumbar disc disease: epidemiology. Instr Course Lect. 1992;41:217–223.

7. Radhakrishnan K, Litchy WJ, O’Fallon WM, Kurland LT. Epidemiology of cervical radiculopathy: A population-based study from Rochester, Minnesota, 1976 through 1990. Brain. 1994;117:325–335. DOI: 10.1093/brain/117.2.325.

8. Mulleman D, Mammou S, Griffoul I, Watier H, Goupille P. Pathophysiology of disk-related sciatica. I. Evidence supporting a chemical component. Joint Bone Spine. 2006;73:151–158. DOI: 10.1016/j.jbspin.2005.03.003.

9. Saal JS, Franson RC, Dobrow R, Saal JA, White AH, Goldthwaite N. High Levels of inflammatory phospholipase A2 activity in lumbar disc herniations. Spine. 1990;15:674–678. DOI: 10.1097/00007632-199007000-00011.

10. Kobayashi S, Yoshizawa H, Nakai S. Experimental study on the dynamics of lumbosacral nerve root circulation. Spine. 2000;25:298–305. DOI: 10.1097/00007632-200002010-00007.

11. Onda A, Murata Y, Rydevik B, Larsson K, Kikuchi S, Olmarker K. Nerve growth factor involvement in pain behavior in a rat model of experimental disc herniation. In: Proceedings of the 31st annual meeting of the International Society for the Study of the Lumbar Spine. May 31 – June 6, 2004, Porto, Portugal.

12. Fager CA. Observations on spontaneous recovery from intervertebral disc herniation. Surg Neurol. 1994;42:282–286. DOI: 10.1016/0090-3019(94)90393-x.

13. Saal JA, Saal JS. Nonoperative treatment of herniated lumbar intervertebral disc with radiculopathy. Spine. 1989;14:431–437. DOI: 10.1097/00007632-198904000-00018.

14. Valat JP, Genevay S, Marty M, Rozenberg S, Koes B. Sciatica. Best Pract Res Cl Rh. 2010;24:241–252. DOI: 10.1016/j.berh.2009.11.005.

15. Dreiser RL, Le Parc JM, Velicitat P, Lleu PL. Oral meloxicam is effective in acute sciatica: two randomised, double-blind trials versus placebo or diclofenac. Inflamm Res. 2001;50 Suppl 1:S17–S23. DOI: 10.1007/PL00022375.

16. National Institute for Health and Care Excellence. Low back pain and sciatica in over 16s: assessment and management (NICE guideline NG59). Published date: 30 November 2016. [Electronic resource]. URL: https://www.nice.org.uk/guidance/ng59.

17. Kreiner DS, Hwang SW, Easa JE, Resnick DK, Baisden JL, Bess S, Cho CH, DePalma MJ, Dougherty P 2nd, Fernand R, Ghiselli G, Hanna AS, Lamer T, Lisi AJ, Mazanec DJ, Meagher RJ, Nucci RC, Patel RD, Sembrano JN, Sharma AK, Summers JT, Taleghani CK, Tontz WL Jr, Toton JF. An evidence-based clinical guideline for the diagnosis and treatment of lumbar disc herniation with radiculopathy. Spine J. 2014;14:180–191. DOI: 10.1016/j.spinee.2013.08.003.

18. Кривошапкин А.Л., Некрасов А.Д., Семин П.А., Гайтан А.С., Сергеев Г.С. Грыжа поясничного межпозвонкового диска: минимально-инвазивная хирургия и альтернативная локомоция. М., 2017. [Krivoshapkin AL, Nekrasov AD, Semin PA, Gaytan AS, Sergeev GS. Lumbar Intervertebral Disc Hernia: Mminimally Invasive Surgery and Alternative Locomotion. Moscow, 2017. In Russian].

19. Fager CA. Malpractice issues in neurological surgery. Surg. Neurol. 2006;65:416–421. DOI: 10.1016/j.surneu.2005.09.026.

20. Aldrete JA. Postlaminectomy syndrome. In: Waldman S.D., ed. Pain Management, 1st ed. Philadelphia, Saunders, 2006:818.

21. Heindel P, Tuchman A, Hsieh PC, Pham MH, D’Oro A, Patel NN, Jakoi AM, Hah R, Liu JC, Buser Z, Wang JC. Reoperation rates after single-level lumbar discectomy. Spine. 2017;42:E496–E501. DOI: 10.1097/BRS.0000000000001855.

22. Азизов М.Ж., Симонович А.Е., Нуралиев Х.А. Результаты анализа дискэктомии у больных с поясничным остеохондрозом // Гений ортопедии. 2010. № 1. С. 59–63. [Azizov MZh, Simonovich AE, Nuraliyev KhA. The results of discectomy analysis in patients with lumbar osteochondrosis. Genij Ortopedii. 2010;(1):59–63. In Russian].

23. Chen X, Chamoli U, Vargas Castillo J, Ramakrishna VAS, Diwan AD. Complication rates of different discectomy techniques for symptomatic lumbar disc herniation: a systematic review and meta-analysis. Eur Spine J. 2020;29:1752–1770. DOI:10.1007/s00586-020-06389-5.

24. Lin EL, Lieu V, Halevi L, Shamie AN, Wang JC. Cervical epidural steroid injections for symptomatic disc herniations. J Spinal Disord Tech. 2006;19:183–186. DOI: 10.1097/01.bsd.0000190558.13248.e1.

25. Costandi SJ, Azer G, Eshraghi Y, Zeyed Y, Atalla JE, Looka ME, Mekhail NA. Cervical transforaminal epidural steroid injections: Diagnostic andtherapeutic value. Reg Anesth Pain Med. 2015;40:674–680. DOI: 10.1097/AAP.0000000000000323.

26. Kesikburun S, Aras B, Kelle B, Yavuz F, Yasar E, Taskaynatan MA. The effectiveness of cervical transforaminal epidural steroid injection for the treatment of neck pain due to cervical disc herniation: long-term results. Pain Manag. 2018;8:321–326. DOI: 10.2217/pmt-2018-0002.

27. Stafford MA, Peng P, Hill DA. Sciatica: a review of history, epidemiology, pathogenesis, and the role of epidural steroid injection in management. Br J Anaesth. 2007;99:461–473. DOI: 10.1093/bja/aem238.

28. Derby R, Kine G, Saal JA, Reynolds J, Goldthwaite N, White AH, Hsu K, Zucherman J. Response to steroid and duration of radicular pain as predictors of surgical outcome. Spine. 1992;17(6 Suppl):S176–S183. DOI: 10.1097/00007632-199206001-00020.

29. Leung SM, Chau WW, Law SW, Fung KY. Clinical value of transforaminal epidural steroid injection in lumbar radiculopathy. Hong Kong Med J. 2015;21:394–400. DOI: 10.12809/hkmj144310.

30. Гуща А.О., Арестов С.О., Древаль М.Д., Кащеев А.А., Вершинин А.В. Клинические рекомендации. Хирургическое лечение грыж межпозвонковых дисков шейного отдела позвоночника. М., 2015. [Gushcha AO, Arestov SO, Dreval MD, Kashcheev AA, Vershinin AV. Surgical Treatment of Cervical Intervertebral Disc Herniation: Clinical Recommendations. Moscow, 2015. In Russian].

31. Хирургия дегенеративных поражений позвоночника / под ред. А.О. Гущи, Н.А. Коновалова, А.А. Гриня, М., 2018. [Surgery for Degenerative Lesions of the Spine, ed. by Gushcha AO, Konovalov NA, Grin AA. Moscow, 2018. In Russian].

32. Gray DT, Deyo RA, Kreuter W, Mirza SK, Heagerty PJ, Comstock BA, Chan L. Population-based trends in volumes and rates of ambulatory lumbar spine surgery. Spine. 2006;31:1957–1963. DOI: 10.1097/01.brs.0000229148.63418.c1.

33. Sherman J, Cauthen J, Schoenberg D, Burns M, Reaven NL, Griffith SL. Economic impact of improving outcomes of lumbar discectomy. Spine J. 2010;10:108–116. DOI: 10.1016/j.spinee.2009.08.453.

34. Gempt J, Jonek M, Ringel F, Preub A, Wolf P, Ryang Y. Long-term follow-up of standard microdiscectomy versus minimal access surgery for lumbar disc herniation. Acta Neurochir (Wien). 2013;155:2333–2338. DOI: 10.1007/s00701-013-1901-z.

35. Rotim K, Sajko T, Boric M, Stipic D, Kovactvic M. Microdiscectomy vs. microdiscectomy using tubular retractor system vs. selective endoscopic discectomy in lumbar disc herniation: a prospective study of functional outcome. In: Abstracts of the 15th World Congress of Neurosurgery, Seoul, Korea. September 8–13, 2013. Abstract FA0905.

36. Machado GC, Witzleb AJ, Fritsch C, Maher CG, Ferreira PH, Ferreira ML. Patients with sciatica still experience pain and disability 5 years after surgery: A systematic review with meta-analysis of cohort studies. Eur J Pain. 2016;20:1700–1709. DOI: 10.1002/ejp.893.

37. Wu PH, Kim HS, Jang IT. Intervertebral disc diseases PART 2: A review of the current diagnostic and treatment strategies for intervertebral disc disease. Int J Mol Sci. 2020;21:2135. DOI: 10.3390/ijms21062135.

38. Sharps LS, Isaac Z. Percutaneous disc decompression using nucleoplasty. Pain Physician. 2002;5:121–126.

39. Albrecht DS, Ahmed SU, Kettner NW, Borra RJH, Cohen-Adad J, Deng H, Houle TT, Opalacz A, Roth SA, Melo MFV, Chen L, Mao J, Hooker JM, Loggia ML, Zhang Y. Neuroinflammation of the spinal cord and nerve roots in chronic radicular pain patients. Pain. 2018;159:968–977. DOI: 10.1097/j.pain.0000000000001171.

40. Heliovaara M, Makela M, Knekt P, Impivaara O, Aromaa A. Determinants of sciatica and low-back pain. Spine. 1991;16:608–614. DOI: 10.1097/00007632-199106000-00002.

41. Parr AT, Manchikanti L, Hameed H, Conn A, Manchikanti KN, Benyamin RM, Diwan S, Singh V, Abdi S. Caudal epidural injections in the management of chronic low back pain: A systematic appraisal of the literature. Pain Physician. 2012;15:E159–E198.

42. Benyamin RM, Manchikanti L, Parr AT, Diwan SA, Singh V, Falco FJE, Datta S, Abdi S, Hirsch JA. The effectiveness of lumbar interlaminar epidural injections in managing chronic low back and lower extremity pain. Pain Physician. 2012;15:E363–E404.

43. Гуща А.О., Герасимова Е.В., Вершинин А.В. Методы интервенционного лечения болевого синдрома при дегенеративно-дистрофических изменениях позвоночника // Анналы клинической и экспериментальной неврологии. 2020. № 14(1). С. 78–88. [Gushcha AO, Gerasimova EV, Vershinin AV. Interventional therapies for the chronic pain in degenerative spine conditions. Annaly klinicheskoy i eksperimental’noy nevrologii. 2020;14(1):78–88. In Russian]. DOI: 10.25692/ACEN.2020.1.9.

44. Manchikanti L, Abdi S, Atluri S, Benyamin RM, Boswell MV, Buenaventura RM, Bryce DA, Burks PA, Caraway DL, Calodney AK, Cash KA, Christo PJ, Cohen SP, Colson J, Conn A, Cordner H, Coubarous S, Datta S, Deer TR, Diwan S, Falco FJ, Fellows B, Geffert S, Grider JS, Gupta S, Hameed H, Hameed M, Hansen H, Helm S 2nd, Janata JW, Justiz R, Kaye AD, Lee M, Manchikanti KN, McManus CD, Onyewu O, Parr AT, Patel VB, Racz GB, Sehgal N, Sharma ML, Simopoulos TT, Singh V, Smith HS, Snook LT, Swicegood JR, Vallejo R, Ward SP, Wargo BW, Zhu J, Hirsch JA. An update of comprehensive evidence-based guidelines for interventional techniques in chronic spinal pain. Part II: guidance and recommendations. Pain Physician. 2013;16(2 Suppl):S49–S283.

45. Benzon HT, Raja SN, Fishman SM, Liu SS, Cohen SP. Essentials of Pain Medicine, 4th edition, ed. by R.W. Hurley. Elsevier, 2019.

46. Hakim BR, Munakomi S. Interlaminar Epidural Injection. StatPearls [Internet]. TreasureIsland (FL): StatPearls Publishing, 2020.

47. House LM, Barrette K, Mattie R, McCormick ZL. Cervical epidural steroid injection: techniques and evidence. Phys Med Rehabil Clin N Am. 2018;29:1–17. DOI: 10.1016/j.pmr.2017.08.001.

48. Stolzenberg D, Ahn JJ, Kurd M. Fluoroscopically guided lumbar transforaminal epidural steroid injection: procedural technique. Clin Spine Surg. 2018;31:297–299. DOI: 10.1097/BSD.0000000000000627.

49. Kao SC, Lin CS. Caudal epidural block: an updated review of anatomy and techniques. BioMed Res Int. 2017;(5):1–5. DOI: 10.1155/2017/9217145.

50. Kim KM, Kim HS, Choi KH, Ahn WS. Cephalic spreading levels after volumetric caudal epidural injections in chronic low back pain. J Korean Med Sci 2001;16:193–197. DOI: 10.3346/jkms.2001.16.2.193.

51. Wong JJ, Cote P, Quesnele JJ, Stern PJ, Mior SA. The course and prognostic factors of symptomatic cervical disc herniation with radiculopathy: a systematic review of the literature. Spine J. 2014;14:1781–1789. DOI: 10.1016/j.spinee.2014.02.032.

52. Lee IS, Kim SH, Lee JW, Hong SH, Choi JY, Kang HS, Song JW, Kwon AK. Comparison of the temporary diagnostic relief of transforaminal epidural steroid injection approaches: conventional versus posterolateral technique. AJNR Am J Neuroradiol. 2007;28:204–208.

53. Manchikanti L, Singh V, Pampat, V, Falco FJ, Hirsch JA. Comparison of the efficacy of caudal, interlaminar, and transforaminal epidural injections in managing lumbar disc herniation: is one method superior to the other? Korean J Pain. 2015;28:11–21. DOI: 10.3344/kjp.2015.28.1.11.

54. Manchikanti L, Singh V, Cash KA, Pampati V, Damron KS, Boswell MV. Effect of fluoroscopically guided caudal epidural steroid or local anesthetic injections in the treatment of lumbar disc herniation and radiculitis: a randomized, controlled, double blind trial with a two-year follow-up. Pain Physician. 2012;15:273–286.

55. Manchikanti L, Singh V, Cash KA, Pampati V, Falco FJ. A randomized, double-blind, active-control trial of the effectiveness of lumbar interlaminar epidural injections in disc herniation. Pain Physician. 2014;17:E61–E74.

56. Manchikanti L, Cash KA, Pampati V, Falco FJ. Transforaminal epidural injections in chronic lumbar disc herniation: a randomized, double-blind, active-control trial. Pain Physician. 2014;17:E489–E501.

57. Singh S, Kumar S, Chahal G, Verma R. Selective nerve root blocks vs. caudal epidural injection for single level prolapsed lumbar intervertebral disc – A prospective randomized study. J Clin Orthop Trauma. 2017;8:142–147. DOI: 10.1016/j.jcot.2016.02.001.

58. Pandey RA. Efficacy of epidural steroid injection in management of lumbar prolapsed intervertebral disc: a comparison of caudal, transforaminal and interlaminar routes. J Clin Diagn Res. 2016;10:RC05–RC11. DOI: 10.7860/JCDR/2016/18208.8127.

59. Kamble PC, Sharma A, Singh V, Natraj B, Devani D, Khapane V. Outcome of single level disc prolapse treated with transforaminal steroid versus epidural steroid versus caudal steroids. Eur Spine J. 2016;25:217–221. DOI: 10.1007/s00586-015-3996-9.

60. Adilay U, Guclu B, Deniz L, Kahveci R. Comparison of the effect of single lumbar transforaminal epidural steroid injections for the treatment of L4– L5 and L5–S1 paramedian disc herniation. Turk Neurosurg. 2019;29:279–284. DOI: 10.5137/1019-5149.JTN.24029-18.1.

61. Makkar JK, Gourav KKP, Jain K, Singh PM, Dhatt SS, Sachdeva N, Bhadada S. Transforaminal versus lateral parasagittal versus midline interlaminar lumbar epidural steroid injection for management of unilateral radicular lumbar pain: a randomized double-blind trial. Pain Physician. 2019;22:561–573.

62. Lee JH, Shin KH, Bahk SJ, Lee GJ, Kim DH, Lee CH, Kim DH, Yang HS, Lee SH. Comparison of clinical efficacy of transforaminal and caudal epidural steroid injection in lumbar and lumbosacral disc herniation: A systematic review and meta-analysis. Spine J. 2018;18:2343–2353. DOI: 10.1016/j.spinee.2018.06.720.

63. Bensler S, Walde M, Fischer MA, Pfirrmann CW, Peterson CK, Sutter R. Comparison of treatment outcomes in lumbar disc herniation patients treated with epidural steroid injections: interlaminar versus transforaminal approach. Acta Radiol. 2020;61:361–369. DOI: 10.1177/0284185119858681.

64. Smith CC, McCormick ZL, Mattie R, MacVicar J, Duszynski B, Stojanovic MP. The effectiveness of lumbar transforaminal injection of steroid for the treatment of radicular pain: a comprehensive review of the published data. Pain Med. 2020;21:472–478. DOI: 10.1093/pm/pnz160.

65. Rados I, Sakic K, Fingler M, Kapural L. Efficacy of interlaminar vs transforaminal epidural steroid injection for the treatment of chronic unilateral radicular pain: prospective, randomized study. Pain Med. 2011;12:1316–1321. DOI: 10.1111/j.1526-4637.2011.01213.x.

66. Ghahreman A, Bogduk N. Predictors of a favorable response to transforaminal injection of steroids in patients with lumbar radicular pain due to disc herniation. Pain Med. 2011;12:871–879. DOI: 10.1111/j.1526-4637.2011.01116.x.

67. Conger A, Cushman DM, Speckman RA, Burnham T, Teramoto M, McCormick ZL. The effectiveness of fluoroscopically guided cervical transforaminal epidural steroid injection for the treatment of radicular pain; a systematic review and meta-analysis. Pain Med. 2020;21:41–54. DOI: 10.1093/pm/pnz127.

68. Hong SJ, Kim DY, Kim H, Kim S, Shin KM, Kang SS. Resorption of massive lumbar disc herniation on mri treated with epidural steroid injection: a retrospective study of 28 cases. Pain Physician. 2016;19;381–388.

69. Bozzao A, Gallucci M, Masciocchi C, Aprile I, Barile A, Passariello R. Lumbar disc herniation: MR imaging assessment of natural history in patients treated without surgery. Radiology 1992;185:135–141. DOI: 10.1148/radiology.185.1.1523297.

70. Cribb GL, Jaffray DC, Cassar-Pullicino VN. Observations on the natural history of massive lumbar disc herniation. J Bone Joint Surg Br. 2007;89:782–784. DOI: 10.1302/0301-620X.89B6.18712.

71. Benson RT, Tavares SP, Robertson SC, Sharp R, Marshall RW. Conservatively treated massive prolapsed discs: a 7-year follow-up. Ann R Coll Surg Engl. 2010;92:147–153. DOI: 10.1308/003588410X12518836438840.

72. Sigmundsson G, Kang XP, Jonsson B, Stromqvist B. Correlation between disability and MRI findings in lumbar spinal stenosis: a prospective study of 109 patients operated on by decompression. Acta Orthop. 2011;82:204–210. DOI: 10.3109/17453674.2011.566150.

73. Lee JC, Cha JG, Yoo JH, Kim HK, Kim HJ, Shin BJ. Radiographic grading of facet degeneration, is it reliable? – A comparison of MR or CT grading with histologic grading in lumbar fusion candidates. Spine J. 2012;12:507–514. DOI: 10.1016/j.spinee.2012.06.003.

74. Vaccaro AR, Rihn JA, Saravanja D, Anderson DG, Hilibrand AS, Albert TJ, Fehlings MG, Morrison W, Flanders AE, France JC, Arnold P, Anderson PA, Friel B, Malfair D, Street J, Kwon B, Paquette S, Boyd M, Dvorak MF, Fisher C. Injury of the posterior ligamentous complex of the thoracolumbar spine: a prospective evaluation of the diagnostic accuracy of magnetic resonance imaging. Spine. 2009;34:E841–E847. DOI: 10.1097/BRS.0b013e3181bd11be.

75. Datta S, Manchikanti L, Falco FJ, Calodney AK, Atluri S, Benyamin RM, Buenaventura RM, Cohen SP. Diagnostic utility of selective nerve root blocks in the diagnosis of lumbosacral radicular pain: systematic review and update of current evidence. Pain Physician 2013;16(2 Suppl):SE97–E124.

76. Dietrich TJ, Sutter R, Froehlich JM, Pfirrmann WA. Particulate versus non-particulate steroids for lumbar transforaminal or interlaminar epidural steroid injections: an update. Skeletal Radiol. 2015;44:149–155. DOI: 10.1007/s00256-014-2048-6.

77. Derby R, Lee SH, Date ES, Lee JH, Lee CH. Size and aggregation of corticosteroids used for epidural injections. Pain Med. 2008;9:227–234. DOI: 10.1111/j.1526-4637.2007.00341.x.

78. El-Yahchouchi C, Geske JR, Carter RE, Diehn FE, Wald JT, Murthy NS, Kaufmann TJ, Thielen KR, Morris JM, Amrami KK, Maus TP. The noninferiority of the nonparticulate steroid dexamethasone vs the particulate steroids betamethasone and triamcinolone in lumbar transforaminal epidural steroid injections. Pain Med. 2013;14:1650–1657. DOI: 10.1111/pme.12214.

79. Zheng P, Schneider BJ, Kennedy DJ, McCormick ZL. Safe injectate choice, visualization, and delivery for lumbar transforaminal epidural steroid injections: evolving literature and considerations. Curr Phys Med Rehabil Rep. 2019;7:414–421. DOI: 10.1007/s40141-019-00244-5.

80. Feeley IH, Healy EF, Noel J, Kiely PJ, Murphy TM. Particulate and non-particulate steroids in spinal epidurals: a systematic review and meta-analysis. Eur Spine J. 2016;26:336–344. DOI: 10.1007/s00586-016-4437-0.

81. Mehta P, Syrop I, Singh JR, Kirschner J. Systematic review of the efficacy of particulate versus nonparticulate corticosteroids in epidural injections. PM R. 2017;9:502–512. DOI: 10.1016/j.pmrj.2016.11.008.

82. Lee JW, Lee E, Lee GY, Kang Y, Ahn JM, Kang HS. Epidural steroid injection-related events requiring hospitalisation or emergency room visits among 52,935 procedures performed at a single centre. Eur Radiol. 2018;28:418–427. DOI: 10.1007/s00330-017-4977-7.

83. Rathmell JP, Michna E, Fitzgibbon DR, Stephens LS, Posner KL. Injury and liability associated with cervical procedures for chronic pain. Anesthesiology. 2011;114:918–926. DOI: 10.1097/ALN.0b013e31820fc7f2.

84. Engel A, King W, MacVicar J. The effectiveness and risks of fluoroscopically guided cervical transforaminal injections of steroids: a systematic review with comprehensive analysis of the published data. Pain Med. 2014;15:386–402. DOI: 10.1111/pme.12304.

85. Anderberg L, Annertz M, Persson L, Brandt L, Saveland H. Transforaminal steroid injections for the treatment of cervical radiculopathy: A prospective and randomised study. Eur Spine J. 2007;16:321–328. DOI: 10.1007/s00586-006-0142-8.

86. Lee SH, Kim KT, Kim DH, Lee BJ, Son ES, Kwack YH. Clinical outcomes of cervical radiculopathy following epidural steroid injection: A prospective study with follow-up for more than 2 years. Spine. 2012;37:1041–1047. DOI: 10.1097/BRS.0b013e31823b4d1f.

87. Lee JH, Lee SH. Comparison of clinical effectiveness of cervical transforaminal steroid injection according to different radiological guidances (C-arm fluoroscopy vs. computed tomography fluoroscopy). Spine J. 2011;11:416–423. DOI: 10.1016/j.spinee.2011.04.004.

88. Park Y, Ahn JK, Sohn Y, Jee H, Lee JH, Kim J, Park KD. Treatment effects of ultrasound guide selective nerve root block for lower cervical radicular pain: a retrospective study of 1- year follow-up. Ann Rehabil Med. 2013;37:658–667. DOI: 10.5535/arm.2013.37.5.658.

89. Kumar N, Gowda V. Cervical foraminal selective nerve root block: a ‘two-needle technique’ with results. Eur Spine J. 2008;17:576–584. DOI: 10.1007/s00586-008-0600-6.

90. Persson L, Anderberg L. Repetitive transforaminal steroid injections in cervical radiculopathy: A prospective outcome study including 140 patients. Evid Based Spine Care J. 2012;3:13–20. DOI: 10.1055/s-0032-1327805.

91. Chung JY, Yim JH, Seo HY, Kim SK, Cho KJ. The efficacy and persistence of selective nerve root block under fluoroscopic guidance for cervical radiculopathy. Asian Spine J. 2012;6:227–232. DOI: 10.4184/asj.2012.6.4.227.

92. Bush K, Mandegaran R, Robinson E, Zavareh A. The safety and efficiency of performing cervical transforaminal epidural steroid injections under fluoroscopic control on an ambulatory/outpatient basis. Eur Spine J. 2020;29:994–1000. DOI: 10.1007/s00586-019-06147-2.

93. Marcia S, Zini C, Hirsch JA, Chandra RV, Bellini M. Steroids spinal injections. Semin Intervent Radiol. 2018;35:290–298. DOI: 10.1055/s-0038-1673421.

94. Manchikanti L, Benyamin RM. Key safety considerations when administering epidural steroid injections. Pain Manag. 2015;5:261–272. DOI: 10.2217/pmt.15.17.

95. Manchikanti L, Nampiaparampil DE, Manchikanti KN, Falco FJ, Singh V, Benyamin RM, Kaye AD, Sehgal N, Soin A, Simopoulos TT, Bakshi S, Gharibo CG, Gilligan CJ, Hirsch JA. Comparison of the efficacy of saline, local anesthetics, and steroids in epidural and facet joint injections for the management of spinal pain: a systematic review of randomized controlled trials. Surg Neurol Int. 2015;6(Suppl 4):S194–S235. DOI: 10.4103/2152-7806.156598.

96. Manchikanti L, Falco FJ, Pampati V, Cash KA, Benyamin RM, Hirsch JA. Cost utility analysis of caudal epidural injections in the treatment of lumbar disc herniation, axial or discogenic low back pain, central spinal stenosis, and post lumbar surgery syndrome. Pain Physician. 2013;16:E129–E143.

97. Bicket MC, Chakravarthy K, Chang D, Cohen SP. Epidural steroid injections: an updated review on recent trends in safety and complications. Pain Manag. 2015;5:129–146. DOI: 10.2217/pmt.14.53.

98. Racoosin JA, Seymour SM, Cascio L, Gill R. Serious neurologic events after epidural glucocorticoid injection–the FDA’s risk assessment. N Engl J Med. 2015;373:2299–2301. DOI: 10.1056/NEJMp1511754.

99. Chiller TM, Roy M, Nguyen D, Guh A, Malani AN, Latham R, Peglow S, Kerkering T, Kaufman D, McFadden J, Collins J, Kainer M, Duwve J, Trump D, Blackmore C, Tan C, Cleveland AA, MacCannell T, Muehlenbachs A, Zaki SR, Brandt ME, Jernigan JA. Clinical findings for fungal infections caused by methylprednisolone injections. N Engl J Med. 2013;369:1610–1619. DOI: 10.1056/NEJMoa1304879.

100. Odonkor CA, Smith B, Rivera K, Chhatre A. Persistent singultus associated with lumbar epidural steroid injections in a septuagenarian: a case report and review. Am J Phys Med Rehabil. 2017;96:E1–E4. DOI: 10.1097/PHM.0000000000000526.

101. Gozal YM, Atchley K, Curt BA. Isolated oculomotor nerve palsy after lumbar epidural steroid injection in a diabetic patient. Surg Neurol Int. 2016;7(Suppl 42):S1099–S1101. DOI: 10.4103/2152-7806.196770.

102. El Abd O, Pimentel DC, Amadera JE. Generalized pruritus as an unusual side effect after epidural injection with dexamethasone. PM R. 2015;7:206–209. DOI: 10.1016/j.pmrj.2014.09.012.

103. Goodman BS, Posecion LW, Mallempati S, Bayazitoglu M. Complications and pitfalls of lumbar interlaminar and transforaminal epidural injections. Curr Rev Musculoskelet Med. 2008;1:212–222. DOI: 10.1007/s12178-008-9035-2.

104. Furman MB, O’Brien EM, Zgleszewski TM. Incidence of intravascular penetration in transforaminal lumbosacral epidural steroid injections. Spine. 2000;25:2628–2632. DOI: 10.1097/00007632-200010150-00014.

105. Cohen SP, Maine DN, Shockey SM, Kudchadkar S, Griffith S. Inadvertent disk injection during transforaminal epidural steroid injection: Steps for prevention and management. Pain Med. 2008;9:688–694. DOI: 10.1111/j.1526-4637.2008.00478.x.

106. Finn KP, Case JL. Disk entry: A complication of transforaminal epidural injection – a case report. Arch Phys Med Rehabil. 2005;86:1489–1491. DOI: 10.1016/j.apmr.2005.03.003.

107. Haspeslagh S, Van Zundert J, Puylaert M, Heylen R, van Kleef M, Vissers K. Unilateral diagnostic infiltration of lumbar l3 nerve root resulting in an inadvertent discogram: the importance of fluoroscopic guidance in interventional pain therapy. Anesthesiology. 2004;100:1019–1021. DOI: 10.1097/00000542-200404000-00038.

108. Trinh KH, Gharibo CG, Aydin SM. Inadvertent intradiscal injection with TFESI utilizing Kambin’s retrodiscal approach in the treatment of acute lumbar radiculopathy. Pain Pract. 2016;16:E70–E73. DOI: 10.1111/papr.12420.

109. Elgafy H, Peters N, Lea JE, Wetzel RM. Hemorrhagic lumbar synovial facet cyst secondary to transforaminal epidural injection: a case report and review of the literature. World J Orthop 2016;7:452–457. DOI: 10.5312/wjo.v7.i7.452.

110. Gharibo CG, Fakhry M, Diwan S, Kaye AD. Conus medullaris infarction after a right L4 transforaminal epidural steroid injection using dexamethasone. Pain Physician. 2016;19:E1211–E1214.

111. Glaser SE, Falco F. Paraplegia following a thoracolumbar transforaminal epidural steroid injection. Pain Physician. 2005;8:309–314.

112. Houten JK, Errico TJ. Paraplegia after lumbosacral nerve root block: Report of three cases. Spine J. 2002;2:70–75. DOI: 10.1016/j.spinee.2004.01.010.

113. Huntoon MA, Martin DP. Paralysis after transforaminal epidural injection and previous spinal surgery. Reg Anesth Pain Med. 2004;29:494–495. DOI: 10.1016/j.rapm.2004.05.002.

114. Kennedy DJ, Dreyfuss P, Aprill CN, Bogduk N. Paraplegia following image-guided transforaminal lumbar spine epidural steroid injection: two case reports. Pain Med. 2009;10:1389–1394. DOI: 10.1111/j.1526-4637.2009.00728.x.

115. Somayaji HS, Saifuddin A, Casey AT, Briggs TW. Spinal cord infarction following therapeutic computed tomography-guided left L2 nerve root injection. Spine. 2005;30:E106–108. DOI: 10.1097/01.brs.0000153400.67526.07.

116. Schneider BJ, Maybin S, Sturos E. Safety and complications of cervical epidural steroid injections. Phys Med Rehabil Clin N Am. 2018;29:155–169. DOI: 10.1016/j.pmr.2017.08.012.

117. Goodman BS, Bayazitoglu M, Mallempati S, Noble BR, Geffen JF. Dural puncture and subdural injection: a complication of lumbar transforaminal epidural injections. Pain Physician 2007;10:697–705.

118. El-Yahchouchi CA, Plastaras CT, Maus TP, Carr CM, McCormick ZL, Geske JR, Smuck M, Pingree MJ, Kennedy DJ. Adverse event rates associated with transforaminal and interlaminar epidural steroid injections: a multi-institutional study. Pain Med. 2016;17:239–249. DOI: 10.1111/pme.12896.


Для цитирования:


Кривошапкин А.Л., Савицкий И.Д., Сергеев Г.С., Гайтан А.С., Абдуллаев О.А. Лечебно-диагностическая ценность трансфораминальных эпидуральных блокад у пациентов с грыжами межпозвонкового диска и корешковой болью: аналитический обзор литературы. "Хирургия позвоночника". 2020;17(3):53-65. https://doi.org/10.14531/ss2020.3.53-65

For citation:


Krivoshapkin A.L., Savitskiy I.D., Sergeev G.S., Gaytan A.S., Abdullaev O.A. Therapeutic and diagnostic value of transforaminal epidural injections in patients with herniated disc and radicular pain: analytical literature review. Hirurgiâ pozvonočnika (Spine Surgery). 2020;17(3):53-65. (In Russ.) https://doi.org/10.14531/ss2020.3.53-65

Просмотров: 84


Creative Commons License
Контент доступен под лицензией Creative Commons Attribution 4.0 License.


ISSN 1810-8997 (Print)
ISSN 2313-1497 (Online)