Efficacy of Lumbar Transforaminal Epidural Steroid Injections with Triamcinolone Versus Dexamethasone for Pain Relief in Lumbar Radiculopathy Due to Prolapsed Intervertebral Disc Herniation: A Prospective, Randomized, Double Blind Study

Aims and Objective: particulate and non-particulate corticosteroids are used in lumbar transforaminal epidural injection (TFESI) for managing pain due to lumbosacral radiculopathy with varied efficacies and side effects. The aim of this study was to compare the efficacy of Triamcinolone and Dexamethasone in lumbar transforaminal epidural injection for low back pain due to disc herniation. Materials and Method: This prospective, randomized double blind study was conducted on eighty patients aged 18-70 years of either sex having chronic lower back pain due to prolapsed intervertebral disc herniation. All patients randomly allocated in 2 groups (40 patients each) and received transforaminal epidural; Group I: Isobaric Bupivacaine (0.25%) 2 ml + Triamcinolone 40 mg diluted in 2ml 0.9% NS and Group II: Isobaric Bupivacaine (0.25%) 2 ml+ Dexamethasone 8 mg (2 ml). Visual analogue score (VAS), adaptation of Oswestry disability index (ODI), patient health questionnaire-9 (phq-9) and complications were recorded after procedure, at 24 hours, day 15th and 1, 3, 6 months. Results: The VAS score was found to be significantly less in group I as compared to group II at 15 days, 1, 3 and 6 months after procedure (p=0.0407, p=0.0132, p=0.0001, p=0.0034 respectively). The % reduction in VAS score was found to be significantly higher in Group I as compared to group II at 15-days, 1-month, 3-months and 6-months. The ODI score and phq-9 score were found to be significantly less in Group I as compared to Group II at 1, 3 and 6 months after procedure. Conclusion: Triamcinolone was found to be superior in pain reduction and functional improvements as compared to dexamethasone.