Comparison of the Temporary Diagnostic Relief of Transforaminal Epidural Steroid Injection Approaches: Conventional versus Posterolateral Technique

Schematic description of the conventional and posterolateral TFESI techniques. In oblique view (A), the needle tip is located in the safe triangle using the conventional technique, and the median inferior margin of pedicle with posterolateral approach. The needle appears end-on in this view. Lateral view (B) shows the needle located in the anterior and superior aspect of a nerve root using the conventional technique and at the posterior aspect using the posterolateral technique. C, conventional TFESI; PL, posterolateral TFESI.

Bar graph showing the number of patients with respect to temporary diagnostic relief according to the 5-point patient outcome scale when interviewed 2 weeks after TFESI. G0 = 0 (aggravated), G1 = 1 (stationary), G2 = 2 (improved), G3 = 3 (much improved), G4 = 4 (no residual symptom).

A 68-year-old female patient with chronic pain of the anterior aspect of the right leg and a tingling sensation in the L4 dermatome. MR imaging (not shown) showed degenerative spondylolisthesis at the L3/4 level with foraminal stenosis. There was no pain relief in follow-up of 2 weeks after a conventional transforaminal epidural steroid injection (TFESI) at the L3 level.