Chronic Unilateral Lumbar Radicular Pain

Effectiveness of Transgrade vs Interlaminar Epidural Steroid Injection for Chronic Unilateral Lumbar Radicular Pain

Chronic neuropathic lumbar pain is among one of the most widespread complaints of patients.Many approaches have been attempted to target chronic pain, with varying efficacy and risks. Transgrade (TG) epidural injection is a new technique using a Racz- Coudé needle for epidural access at a "transgrade" angle without requiring any specialized hardware or accessories. Interlaminar (IL) epidural steroid injection (ESI) is one of the procedures that involves the delivery of injectate to the epidural space through directing a needle between the laminae of two adjacent vertebrae.

Inclusion Criteria:

• > 6-month history of persistent pain in one leg with back pain.
• Capable of giving informed consent.
• Unsatisfactory response to conventional treatments including physical therapy or medications with a numeric rating scale (NRS) ≥ 5.

Exclusion Criteria:

• Previous lumbar spinal surgery.
• Myelopathy.
• Rheumatoid disorders.
• Psychiatric disorders
• Bleeding or coagulation disorders