Kambin Triangle Versus the Supraneural Approach for the Treatment of Lumbar Radicular Pain

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ObjectiveThe aim of this study was to conduct a randomized, blinded, prospective outcome study on the short-term benefits of the Kambin triangle vs. the supraneural approach for the treatment of lumbar radicular pain.DesignSubjects with lumbar radicular pain (n = 100) were randomly assigned to undergo transforaminal epidural steroid injection using either the Kambin triangle approach or the supraneural approach. Primary outcomes were measured with a verbal numeric pain scale and the Oswestry Disability Index, and the results at 2 and 12 wks after the procedure were compared between the groups. Secondary outcomes included patient satisfaction and the incidence of complications during the transforaminal epidural steroid injection procedure.ResultsFor both groups, the verbal numeric pain scale and Oswestry Disability Index scores improved 2 wks after the injections, and this improvement was maintained through the 12-wk follow-up. The verbal numeric pain scale, Oswestry Disability Index, and effectiveness scores were not significantly different between groups. Neural contact occurred in nine cases with the supraneural approach; no patients experienced neural contact with the Kambin triangle approach.ConclusionsThe Kambin triangle approach can be used instead of the supraneural approach in cases where it is difficult to place the needle at the anterior epidural space.

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