Lumbar endoscopic transforaminal decompression improved with lidocaine injections: 3 study findings

A study in Clinical Neurology and Neurosurgery analyzed the positive predictive value of diagnostic 1 percent lidocaine containing transforaminal epidural steroid injections after outpatient endoscopic decompression for lumbar foraminal and lateral recess stenosis.

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The study comprised 1,839 patients who underwent endoscopic transforaminal decompression at 2,076 lumbar levels.

Here are three study findings:

1. Of the total patients, 1,750 had intraoperatively visualized stenosis in the lateral recess at the surgical level while 89 patients did not.

2. Results for patients with visualized compressive pathology were:

• True positive — 1,578 patients
• False negative — 172 patients

3. Results for patients without visualized compressive pathology were:

• False positive — 26 patients
• True negative — 63 patients

Study authors concluded, “The expected [visual analog scale] pain reduction from a lidocaine containing transforaminal epidural steroid injection renders it a valuable diagnostic tool in improving clinical outcome after lumbar endoscopic transforaminal decompression.”

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