Patients with lumbosacral radiculopathy frequently experience neuropathic pain due to nerve root compression. Transforaminal epidural steroid injection (TFESI) is commonly used for pain relief in these patients. This study aims to evaluate the effect of TFESI on neuropathic pain severity using the Neuropathic Pain Scale (NPS) in patients with lumbosacral radiculopathy. Clinical outcomes before and after the procedure will be compared.
Adults aged 18 years and older
Patients diagnosed with lumbosacral radiculopathy based on clinical evaluation and lumbar MRI findings
Presence of neuropathic pain symptoms associated with lumbosacral radiculopathy
Patients scheduled to undergo transforaminal epidural steroid injection (TFESI)
Previous lumbar spinal surgery
Cauda equina syndrome or progressive neurological deficit
Spinal malignancy, infection, or acute vertebral fracture
Pregnancy or breastfeeding
Single group
Transforaminal Epidural Steroid Injections
Procedure/SurgeryTransforaminal epidural steroid injection will be performed under fluoroscopic guidance for the treatment of lumbosacral radiculopathy.
Change in Neuropathic Pain Severity Assessed by the Neuropathic Pain Scale (NPS)
hange in Neuropathic Pain Severity Assessed by the Neuropathic Pain Scale (NPS) The primary outcome measure is the change in neuropathic pain severity assessed using the Neuropathic Pain Scale (NPS) before and after transforaminal epidural steroid injection (TFESI) in patients with lumbosacral radiculopathy. The NPS ranges from 0 to 100, with higher scores indicating greater neuropathic pain severity (worse outcomes). Changes in NPS scores will be assessed from baseline to 3 weeks and 3 months after the intervention.
Change in Pain Intensity Assessed by Numeric Rating Scale (NRS)
hange in Pain Intensity Assessed by the Numeric Rating Scale (NRS) Pain intensity will be evaluated using the Numeric Rating Scale (NRS) before and after transforaminal epidural steroid injection (TFESI) in patients with lumbosacral radiculopathy. The NRS ranges from 0 to 10, with higher scores indicating greater pain intensity (worse outcomes). Changes in NRS scores will be assessed from baseline to 3 weeks and 3 months after the intervention.
Change in Neuropathic Pain Symptoms Assessed by Douleur Neuropathique 4 (DN4)
Change in Neuropathic Pain Symptoms Assessed by the Douleur Neuropathique 4 (DN4) Questionnaire Neuropathic pain symptoms will be evaluated using the Douleur Neuropathique 4 (DN4) questionnaire before and after transforaminal epidural steroid injection (TFESI) in patients with lumbosacral radiculopathy. The DN4 score ranges from 0 to 10, with higher scores indicating more severe neuropathic pain symptoms (worse outcomes). Changes in DN4 scores will be assessed from baseline to 3 weeks and 3 months after the intervention.
Change in Functional Disability Assessed by Oswestry Disability Index (ODI)
Change in Functional Disability Assessed by the Oswestry Disability Index (ODI) Functional disability and limitations in daily living activities will be evaluated using the Oswestry Disability Index (ODI) before and after transforaminal epidural steroid injection (TFESI) in patients with lumbosacral radiculopathy. The ODI score ranges from 0 to 100, with higher scores indicating greater functional disability (worse outcomes). Changes in ODI scores will be assessed from baseline to 3 weeks and 3 months after the intervention.
Association Between Contrast Dispersion Pattern and Clinical Outcomes
The change in neuropathic pain severity according to the epidural contrast dispersion pattern observed during transforaminal epidural steroid injection (TFESI) will be evaluated. The epidural contrast dispersion pattern will be classified as intraneural, extraneural, or paraneural based on fluoroscopic imaging of contrast distribution around the nerve root. Neuropathic pain severity will be assessed using the Neuropathic Pain Scale (NPS), which ranges from 0 to 100, with higher scores indicating greater neuropathic pain severity (worse outcomes). The change in NPS score from baseline will be compared among the three contrast dispersion pattern categories.
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