913 - Analysis of factors affecting the overall outcome of lumbar transforaminal epidural steroid injections in academic practice setting

Objectives: Lumbar transforaminal epidural steroid injections (TFESIs) are commonly used for the treatment of chronic back pain in conditions like degenerative disc disease, disc herniation, spinal stenosis, and more. Although the analgesic benefits of lumbar TFESIs are well-documented, there is limited understanding of the factors that might affect their efficacy and outcomes. Existing studies have researched some of the potential factors affecting outcomes of lumbar TFESIs, but are often limited by smaller sample sizes or neglect additional important factors. Various factors often preclude patients from receiving this intervention. The objective of this study was to assess the factors affecting the early outcomes and efficacy of lumbar TFESI in improving pain level of patients receiving treatment in academic medical centers.

Design: Back pain was assessed with a pain numerical rating scale (NRS) from 0 to 10 prior to receiving lumbar TFESI and at a minimum 2-week follow-up. Minimal clinically important difference (MCID) was defined as NRS change greater than or equal to 2.0. Factors that were assessed included age, sex, diagnosis, length of symptoms, surgical history, and insurance carrier. Descriptive analyses were performed, and t-tests were used to determine if there were statistical differences between the MCID met/MCID not met groups.

Results: The final analysis included 633 patients. There were no significant differences between groups related to patient race (p = .825), ethnicity (p = .055), age (p = .084), sex (p = .75), insurance carrier (p = .813), diagnosis (p = .667) length of symptoms (p = .934), or surgical history (p = .364).

Conclusions: The results of this study support the idea that no single factor assessed in this study, significantly affects the outcome of lumbar TFESIs. This provides evidence that meaningful improvement can occur in patients who would otherwise be advised against this intervention due to personal factors.