Yüksel, Mehmet OnurAy Kolutek, BilgehanBesnek, AtakanErdoğan, Barış2025-11-102025-11-102024Yüksel, M. O., Ay Kolutek, B., Besnek, A. ve Erdoğan, B. (2024). Comparison of the results of combined epidural steroid injection with other approaches in lumbar disc herniation a retrospective study. Nigerian Journal of Clinical Practice, 27(10), 1135-1140. http://dx.doi.org/10.4103/njcp.njcp_47_241119-30772229-7731http://dx.doi.org/10.4103/njcp.njcp_47_24https://hdl.handle.net/20.500.12511/13183Background: Epidural steroid injection (ESI) is a minimally invasive treatment for lumbar disc herniation (LDH). It can be applied using a transforaminal (TFESI), interlaminar (ILESI), caudal (CESI), or combined (TFESI + CESI) approach. Aim: To compare the effectiveness of the three ESI approaches and the combined ESI application in reducing pain in patients with single or multi-level LDH. Methods: In this retrospective study, we included 239 patients diagnosed with LDH (who complained of low back pain for at least 3 months, had no neurological deficit or history of lumbar surgery, and were not contraindicated for ESI application) who received ESI and were followed up clinically for 2 years. Demographic (age, sex, body mass index (BMI)) and clinical data (duration of low back pain, visual analog scale (VAS) scores before and after ESI, and procedure-related information) were obtained from medical records. The VAS scores noted before treatment and at 3 months, 1 year, and 2 years after ESI were compared. Results: The post-treatment VAS scores of the combined ESI (TFESI + CESI) group were significantly lower than those of other approaches applied alone (P < 0.05). Furthermore, VAS scores of the ILESI and CESI groups were significantly lower than those of the TFESI group at all three post-treatment time points (P < 0.05). The patient’s age and BMI were weakly correlated with the post-treatment VAS scores. Conclusion: Combined ESI is more effective than any single-approach ESI in LDH and should be considered in suitable patients to increase treatment effectiveness.eninfo:eu-repo/semantics/embargoedAccessAnestheticsLow Back PainSteroidsArticle27101135114010.4103/njcp.njcp_47_24Q3WOS:0013460032000052-s2.0-85208535066Q2