Percutaneous Laser Disc Decompression versus Transforaminal Epidural Steroid Injection in Lumbar Radicular Pain: The Role of Disc Herniation–Nerve Root Contact

Abstract

Aim: To compare the effectiveness of percutaneous laser disc decompression (PLDD) and transforaminal epidural steroid injection with local anesthetic (ESI TF) in participants with lumbar radicular pain caused by intervertebral disc herniation, depending on the presence of disc herniation with nerve root contact. Methods: A prospective observational study was conducted on 116 participants with unilateral lumbar radicular pain caused by intervertebral disc herniation. Participants were stratified according to the presence of disc herniation in contact with the nerve root and then according to the type of procedure performed. Pain intensity was assessed using the visual analogue scale (VAS), and functional disability was assessed using the Oswestry Disability Index (ODI). Measurements were performed before the procedure and after one, three and six months of follow-up. Results: In participants with herniated disc and nerve contact, pain was significantly lower in participants who received PLDD compared to ESI TF 30 days after the intervention (P = 0.03), three months after the intervention (P = 0.003) and six months after the intervention (P = 0.004). Analysis of ODI categories showed no consistent difference between treatment methods during follow-up. Conclusion: Both minimally invasive methods were associated with pain reduction, and PLDD showed a better effect in reducing pain in participants with herniated disc and nerve root contact. The analysis of functional disability did not show a consistent difference between the methods. Trial registration: ClinicalTrials.gov NCT05601791.