The Effect of Comorbid Psychiatric Conditions on Results of Transforaminal Epidural Steroid Injection

The Effect of Comorbid Psychiatric Disorders and Information Leaflet on Results of Transforaminal Epidural Steroid Injection

Low back pain (LBP) and radiculopathic pain are a major socio-economic problem affecting all age groups. 70% of people consult a doctor at least once in their life due to LBP. Radicular pain is thought to be caused by inflammation of the spinal nerve roots near the intervertebral disc injury. In this context, fluoroscopic guided transforaminal epidural steroid injection (TFESI) has been increasingly preferred in patients who can not benefit from conservative approach in the treatment of lumbosacral radiculopathic pain due to lumbar disc herniation in recent years.

The assessment of comorbid psychiatric conditions such as depression, anxiety, and somatization disorder and given the detailed and visual information to patients who will be undergone TFESI could affect the result of the treatment in a good way. The pain questionnaire used for objectively evaluating injection outcomes is personality dependent and there are many factors that can affect it.

Although information leaflets given to patients prior to surgical or non-surgical interventions have not yet been used as a standard in each clinic, the effects on patients have been frequently researched in recently. A detailed description of the treatment, the devices to be used and the disclosure of the steps of the procedure may have an effect on the result of the treatment. The aim of the study; (1) the presence of comorbid psychiatric conditions in patients with lumbar disc hernia and radiculopathy, (2) to evaluate the effect of the written and visual informative form given before the injection of the lumbosacral TFESI.

Inclusion Criteria:

• lumbar radiculopathy due to lumbar disc herniation,
• unresponsive to conservative treatments,
• duration of pain is less than 3 months,
• patients scheduled for the first time with TFESI.

Exclusion Criteria:

• the cases when fluoroscopy or epidural injection is contraindicated (coagulation disorders, pregnancy etc...),
• underwent epidural injection in the last 6 months,
• to have a history of lumbar spinal surgery,
• inflammatory diseases (rheumatoid arthritis, spondyloarthropathy),
• spinal infection or malignancy,
• to benefit from six-week medical treatment,
• be reluctant to participate in the work and follow up,
• who are illiterate,
• the patients with psychiatric disease