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Background and Aims Administration of steroids in lumbar transforaminal epidural injection in lumbar radicular pain is considered one of the preferred treatment methods, though associated with some complications. Adding magnesium sulfate to local anesthetics has potentiate the effects of peripheral and neuraxial blocks. The effects and side effects of triamcinolone and magnesium sulfate in the lumbar transforaminal epidural injections are investigated in the present study.

Methods Sixty patients, aged 40 - 70 years, suffering from unilateral lumbar radicular pain arising from the lumbar disc protrusion were equally divided into two groups of triamcinolone (T) and magnesium (M). They all underwent fluoroscopic guided lumbar transforaminal epidural injections. In the T group, the injection solution contained triamcinolone (20 mg) plus ropivacaine (0.2%), and in M group was magnesium (150mg) plus ropivacaine (0.2%). If the spinal nerve involvement was in two levels, the same injection solution would be repeated. Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) were measured at 0, 2 weeks, 1, and 3 months post-procedure. The potential complications were evaluated.

Results There was a statistically significant improvement in pain score (VAS) and functional disability (ODI) during the measurement times in the both groups (p<0.05). The pain intensity and disability index were not significantly different between the triamcinolone and magnesium groups (p>0.05). No complications were observed in both groups.

Conclusions The lumbar transforaminal epidural injection with triamcinolone or magnesium attenuates lumbar radicular pain. In patients where corticosteroid is not a suitable adjuvant to local anesthetic, or its use is limited, magnesium may be an appropriate alternative.