Eight randomized controlled trials including 771 patients (366 in steroid and 405 in comparator groups) were included. There was variability in the studies in the dose of TFE steroids, frequency, and number of procedures. Patients who received TFE steroids reported a significant, but clinically modest, reduction in mean pain scores (0-10 scale) compared with LA/saline (- points; 95% confidence interval, - to - points; P < , I² = 90%; GRADE weak recommendation; moderate-quality evidence) at 3 months after the interventions. TFE steroids did not decrease physical disability at 1 to 3 months after the intervention (GRADE strong recommendation ↓; high-quality evidence) or incidence of surgery at 12 months after the intervention (GRADE strong recommendation ↓; moderate-quality evidence) compared with LA/saline.
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What are the risks and side effects?
Generally speaking, transforaminal injections are is safe. However, with any procedure there are risks, side effects and possibility of complications. The most common side effect is pain from the actual injection once the local anesthetic wears off and this pain is temporary. The other uncommon risk involve spinal puncture with headaches, infection, bleeding inside the epidural space, nerve damage and worsening of symptoms. Other uncommon risks are related to the side effects of the long acting steroid such as weight gain, increase in blood sugar in diabetics, water retention and suppression of body's own natural production of steroids.