PHILADELPHIA — Transforaminal epidural steroid injections were safe for treating severe spinal stenosis in a review of 114 patients.
Transforaminal epidural steroid injections (TESI) have traditionally been avoided in patients with severe spinal stenosis because of TESI's theoretical potential to trigger neurologic compromise. But TESI are proven effective for managing radicular pain due to spinal stenosis or herniated disk, making the treatment an attractive option for patients who are either unwilling to undergo decompressive spinal surgery or have medical contraindications for surgery, Rajeev K. Patel, M.D., said at the annual meeting of the North American Spine Society.
Dr. Patel and his associates reviewed the experience using TESI to treat patients with severe spinal stenosis at the University of Rochester (N.Y.) Spine Center.
Severe stenosis was defined as a central canal diameter of 5 mm or less.
The 114 patients treated with TESI ranged in age from 15 to 94 years, with an average age of 66. The average duration of spinal stenosis was 1 year. Patients received 1–6 injections, with most patients receiving 2–4 injections.
Patients had no major neurologic complications secondary to their injections, reported Dr. Patel, a spine rehabilitation physician at the University of Rochester. Five patients had symptomatic complaints following TESI, but these resolved in four patients in 6–8 weeks.
Additional studies are needed to further assess the safety of TESI in patients with severe spinal stenosis, Dr. Patel said.