Transforaminal Epidural Steroid Injections for Acute Lumbosacral Radicular Syndrome without prior consultation with a neurologist or diagnostic imaging. - Fast-track TFESI for LRS

Amsterdam UMC0 sites20 target enrollmentStarted: TBDLast updated: April 9, 2024

Conditions

Trial Snapshot

No summary available.

•- Male/female, 20 to 50 years
•- Patients with a first time presentation of aLRS in the involved dermatome
•- Pain radiating in the leg, following spinal segments L4, L5 or S1
•- Predominantly leg pain
•- Pain score of NRS *6
•- The symptoms are present for less than six months
•- There is no indication for immediate referral to a neurologist or
•neurosurgeon, according to the Dutch lumbosacral radicular syndrome guideline.
•- Subject is able and willing to provide informed consent
•- Subject is able and willing to comply with the protocol and follow-up schedule
•The current guideline from the Dutch Spine Society provides extensive screening
•methods to diag-nose aLRS. For instance, prominent leg pain, typical
•dermatomeric pain and increase in radiating pain at pressure-increasing moments
•have shown to be strong predictors of nerve root compression.1 If anamnesis
•shows there is a chance of underlying suffering (exclusion criteria), patients
•are referred to a neurologist, conform the guideline.

•- History of back surgery
•- History of LRS with radiation that follows the same side and segmental pattern
•- Pain present since recent trauma
•- Unexplained weight loss
•- Severe back pain with fever
•- Predominantly back pain during the night
•- Previous Borrelia Burgdorferi infection
•- Patient has a (history of) malignancy
•- Bilateral limb pain
•- Predominantly back pain of *50%
•- Pain score of NRS <6
•- Cauda equina syndrome or acute severe paresis or progressive paresis (within
•a few days)
•- History of coagulation disorders
•- Pregnancy or breastfeeding
•- Immunocompromised
•- Previous adverse reactions to contrast agents, methylprednisolone or

Sponsor

Amsterdam UMC