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Rate ePoster

Pain and Spine Medicine

Effects of Laterality of Injection and Lateral Listhesis on Outcomes of Transforaminal Epidural Steroid Injections in Patients with Spinal Stenosis Associated with Lumbar Scoliosis

Thursday, October 23, 2025
5:00 PM - 6:30 PM MT
Location: Open Kiosks
Has Audio

    Poster Presenter(s)

  • Tyler MacNeil, BA

    Medical Student
    University of Connecticut School of Medicine
    Branford, Connecticut

    • Co-Author(s)

  • OK

    Owen Karsmarski, MD

    Orthopedic Surgery Resident PGY-2
    University of Connecticut School of Medicine - - Farmington, CT
    Farmington, Connecticut

  • AS

    Amanda Spraggs-Hughes, PhD

    Director of Research
    UConn Health
    Farmington, Connecticut

  • IM

    Isaac L. Moss, MD

    Professor and Chair
    Department of Orthopedic Surgery, UCONN Health
    Farmington, Connecticut

  • DS

    Durgadas P. Sakalkale, MD

    Associate Professor Dept of Orthopedic Surgery
    UConn School of Medicine
    Farmington, Connecticut

Disclosure(s):
Tyler MacNeil, BA: No financial relationships to disclose
Durgadas P. Sakalkale, MD: No financial relationships to disclose
Background and/or Objectives: Although transforaminal epidural steroid injections (TFESIs) are commonly used for treatment in patients with lumbar spinal stenosis, there is a paucity of literature on their use in patients with stenosis associated with degenerative lumbar scoliosis. The goals of this study include assessing anatomical and structural factors which might affect TFESI efficacy and whether positive response with TFESI predicts outcomes of subsequent lumbar surgery.

Design: This is a retrospective cohort study made up of 149 patients.

Setting : Patients were treated at an academic medical center from 2018 to 2023. A clinical chart review was completed for each patient.

Participants : Patients all had stenosis associated with degenerative lumbar scoliosis and underwent TFESI for axial and radicular pain.

Interventions: Each patient had previously underwent a TFESI and was followed up with within 2 weeks of injection. A subset of patients underwent subsequent lumbar surgery.

Main Outcome Measures: Patients were assessed with a pain numerical rating scale (NRS, score 0-10) prior to TFESI and at minimum two weeks after injection. A net change in NRS of at least 2.0 demonstrated clinically significant improvement. Variables analyzed against TFESI efficacy include injection laterality, Cobb’s angle, and lateral listhesis. Symptom improvement after lumbar surgery was compared with history of previous TFESI.

Results: We found an improvement in TFESI efficacy for injections completed on the convex side of the scoliosis curve over concave side when patients had radicular pain at the L5-S1 level (p = 0.037). There was a 100% positive predictive value for prior successful TFESI to predict surgery success. We observed a trend for higher lateral listhesis to improve TFESI efficacy.

Conclusions: In the treatment of degenerative lumbar scoliosis, injections performed on the convex side of the primary lumbar scoliosis curve provide higher symptom relief than the concave side at the L5-S1 level. A history of symptom relief with TFESI positively predicts lumbar surgery outcomes.