Objective: This study compared the effectiveness of transforaminal epidural steroid injection (TFESI) alone with that of combined transforaminal and caudal epidural steroid injection (CESI) in multi-level lumbar disc disease, which does not require surgery and does not respond to conservative treatment. Materials and Methods: A total of 99 patients, who were administered TFESI alone or in combination with CESI for radicular pain between November 2018 and August 2019, were analysed retrospectively. Results: The visual analogue scale (VAS) and the Oswestry Disability index (ODI) scores of the patients were evaluated in the pre-injection and post-injection periods in the 3rd week, 3rd month and 6th month. Both the ODI and VAS scores were significantly lower in the early and late post-injection periods than in the pre-injection period in both groups. Combined TFESI and CESI for multi-level lumbar disc disease provided significant improvement in pain management and functional capacity compared with TFESI alone. Conclusion: Combined transforaminal and CESIs should be considered in patients with multi-level lumbar disc disease, which is difficult to manage.
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