Joswig H, et al. – This study was performed to investigate the value of short–term pain relief in predicting the long–term outcome of lumbar transforaminal epidural steroid injections. Most patients with a symptomatic lumbar disc herniation who opt for a second injection or surgery following a transforaminal epidural steroid injection, did so within the first 6 months. Based on short–term pain relief, a reliable prediction of the long–term treatment response was not possible.

• The recruitment included a prospective cohort of n=57 patients who underwent transforaminal epidural steroid injection for sciatica secondary to a lumbar disc herniation, followed for 24 months.
• The authors evaluated leg and back pain on the visual analog scale, health-related quality of life with the Short Form-12 and functional outcome with the Oswestry Disability Index.
• They defined responders as not receiving any additional invasive treatment after a single injection.
• They defined patients who underwent a second injection or surgery as treatment failures (=nonresponders).

• In this study, 31 (54.4%) patients were responders and 26 (45.6%) were nonresponders at 24 months.
• The follow-up was exited by nonresponders at 1 month (n=9), at 3 months (n=9), at 6 months (n=6) and at 12 months (n=2).
• Between the 12- and 24-month follow-up, no patients were injected again or operated on.
• Compared to nonresponders, responders at 24 months had significantly lower visual analog scale leg pain (p<0.05), starting from the second week after TFESI, as well as better Short Form-12 scores and less disability on the Oswestry Disability Index.