The Effect of Obesity on the Treatment Outcomes of Lumbar Transforaminal Epidural Steroid Injections.

Abstract

Aim: The aim of this study is to investigate the effect of obesity on the treatment outcomes of lumbar transforaminal epidural steroid injections (TFESIs).

Material and methods: This retrospective study included patients who underwent single-level TFESI in a pain management center between January 2021 and April 2023. Body mass index (BMI) of the patients was evaluated based on the World Health Organization guidelines. Non-obese individuals had a BMI below 25 kg/m2, those with a BMI between 25 and 30 kg/m2 were classified as overweight, and those with a BMI greater than or equal to 30 kg/m2 were deemed obese. The Numeric Rating Scale (NRS) scores for all patients before the procedure, at the first hour, and at the one-month follow-up were documented. Treatment success was defined as a 50% or more reduction in NRS score at one month of follow-up.

Results: This study enrolled a total of 162 participants, with a mean age of 49.5 ± 13.7 years and an average BMI of 27.7 ± 4.36 kg/m2. The mean pre-procedural pain score was 8.3 (range, 4 to 10). Significant reductions were observed in the mean pain scores at the first hour (0.90) and first month (3.3), compared to the pre-procedural NRS scores (p .001). Upon categorizing patients based on BMI, no significant differences were observed among the groups regarding age, gender, symptom duration, procedure level, magnetic resonance imaging (MRI) grade, pain scores, and treatment success.

Conclusion: Since the potential effects of obesity on the short-term results of lumbar TFESI have not been elucidated yet, practitioners should continue to apply lumbar TFESI in patients with high BMI values.