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Background and Aims Chronic LBP is a disabling chronic pain condition causing excessive burden on health services and severely affecting the quality of life. The study aims to compare TFESI with high-volume lumbar ESP block in patients with low backache and radicular pain.

Methods After institution’s ethical committee clearance, this prospective, randomised controlled study was conducted in patients aged 18-50 yrs, ASA I/II having single-level lumbar disc herniation with radiculopathy not responding to medications were included, whereas, patient refusal, coagulation disorders, allergy to LA, H/O spinal surgery, spinal injury, or deformities, ≥ 2 levels of disc hernia, degenerated and sequestered disc were excluded. Sixty patients were randomly allocated into 2 groups of 30 each- Group T and Group E. Group ESP (E) using 30 ml of 0.25% Bupivacaine + Triamcinolone 20 mg using USG. Group TFESI (T) 2.0 ml of 0.25% Bupivacaine + Triamcinolone 20 mg using Fluoroscopy. The primary objective is to compare the pain relief using the NRS scale at immediate post-intervention, at 1& 3 mo. To compare improvement in disability using modified Oswestry disability index (MODI), requirement of rescue analgesia were secondary.

Results The mean NRS and MODI in group T were significantly lower than in group E (p<0.05). NRS and MODI were significantly lower in both groups post treatment (p<0.001). The requirement of rescue analgesics were significantly higher in group E (p<0.03).

Conclusions Both TFESI and ESP are effective in low backache with radiculopathy: TFESI provided better control of pain. However, compared to ESP more complications were observed in TFESI group.