Caudal Versus S1 Transforaminal Epidural Steroid Injection for the Treatment of Unilateral S1 Radiculopathy

Study Overview
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Brief Summary
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To compare the efficacies of two different interventional techniques (Caudal epidural steroid injection and S1 transforaminal epidural steroid injection) for the treatment of unilateral S1 radiculopathy.

Detailed Description
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Epidural steroid injections are commonly performed for the treatment of radicular pain resulting from a disc herniation. There are 3 different methods to deliver steroids to epidural area which are caudal, interlaminar and transforaminal routes. Lower lumbar and sacral radiculopathies can be managed with caudal epidural steroid injection which is generally quite easier to perform in comparison to transforaminal injection. Transforaminal epidural injection provides injectate to reach anterior epidural area and is the most target specific technique among others. In the present study investigators aim is to compare the success rates of these two different procedures regarding unilateral S1 radiculopathy. The patients referring to the pain medicine outpatient clinic of a university hospital for unilateral radicular pain and diagnosed S1 radiculopathy were planned to be randomized into these two different intervention groups.

Official Title
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Caudal Versus S1 Transforaminal Epidural Steroid Injection for the Treatment of Unilateral S1 Radiculopathy

Conditions
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Lumbosacral Radiculopathy

Intervention / Treatment
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* Procedure: Transforaminal epidural steroid injection
* Procedure: Caudal epidural steroid injection


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Unilateral radicular pain resulting from a paracentral L5-S1 disc herniation causing S1 nerve root compression. Exclusion Criteria: History of previous surgery, pregnancy, neurological disorders, bleeding diathesis, contrast medium allergy, spinal disorders, rheumatologic diseases

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Patients having radicular pain were randomized to either caudal or transforaminal epidural injection group
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: S1 transforaminal<br>The group receiving S1 transforaminal epidural steroid injection | Procedure: Transforaminal epidural steroid injection<br>* Fluoroscopy-guided transforaminal epidural injection for radicular pain resulting from a disc herniation.<br>|
| Active Comparator: Caudal<br>The group receiving caudal epidural steroid injection | Procedure: Caudal epidural steroid injection<br>* Fluoroscopy-guided caudal epidural injection for radicular pain resulting from a disc herniation.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 50 percent pain relief | Number of patients having at least 50 percent pain relief | 3 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Oswestry Disability Index | Improvement in disability scores, 0 is the best, 100 is the worst score. | 3 months | 
| Procedure time | The overall ease of application regarding procedure time. | during procedure | 
| Radiation exposure | The exposed radiation dose during the procedures | during procedure | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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epidural injection, radicular pain, disc herniation, lumbosacral radiculopathy, transforaminal injection, caudal injection