Role of Transforaminal Injection in Non-Surgical Cases of Sciatica
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Background: Sciatica is a common lumbosacral radicular pain syndrome associated with pain, disability, and reduced functional capacity. Transforaminal epidural steroid injection is used as a targeted minimally invasive intervention in non-surgical cases, but local evidence regarding functional outcomes remains limited. Objective: To assess short-term functional improvement after transforaminal epidural steroid injection among non-surgical patients with sciatica and to identify clinical predictors of treatment efficacy. Methods: This descriptive case series was conducted at Punjab Institute of Neurosciences, Lahore, from March to September 2023. Eighty-five patients aged 25–65 years with clinically diagnosed sciatica received transforaminal epidural steroid injection using triamcinolone acetonide with levobupivacaine. Functional disability was assessed using the Oswestry Disability Index before treatment and at 12-week follow-up. Efficacy was defined as a reduction of more than 10 ODI points. Results: The mean age was 48.07 ± 4.71 years. ODI improved from 53.04 ± 0.72 before treatment to 31.65 ± 11.78 at 12 weeks, with a mean reduction of 21.35 ± 11.69 points (p < 0.001). Efficacy was achieved in 56 patients (65.9%). BMI ≤25 kg/m² (OR = 2.85, 95% CI: 1.12–7.21; p = 0.028) and symptom duration ≤14 days (OR = 3.45, 95% CI: 1.39–8.54; p = 0.007) independently predicted treatment response. Conclusion: Transforaminal epidural steroid injection was associated with significant short-term functional improvement in non-surgical sciatica, particularly among patients with lower BMI and shorter symptom duration.
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