{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T15:37:30Z","timestamp":1787240250119,"version":"build-2736575974"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,11,12]]},"DOI":"10.7759\/cureus.48701","type":"journal-article","created":{"date-parts":[[2023,11,12]],"date-time":"2023-11-12T20:26:03Z","timestamp":1699820763000},"source":"Crossref","is-referenced-by-count":5,"title":["Traditional Safe Triangle Approach Versus Kambin\u2019s Triangle Approach: Does Approach Really Matter in Transforaminal Epidural Steroid Injection (TFESI) for Lumbar Disc Herniation?"],"prefix":"10.7759","author":[{"given":"Sandesh","family":"Agarawal","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manoj K","family":"Ramachandraiah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1155\/2021\/5558138","article-title":"Ultrasound-guided transforaminal injections of platelet-rich plasma compared with steroid in lumbar disc herniation: a prospective, randomized, controlled study","volume":"2021","author":"Xu Z","year":"2021","unstructured":"Xu Z, Wu S, Li X, Liu C, Fan S, Ma C. Ultrasound-guided transforaminal injections of platelet-rich plasma compared with steroid in lumbar disc herniation: a prospective, randomized, controlled study. Neural Plast. 2021, 2021:5558138. 10.1155\/2021\/5558138","journal-title":"Neural Plast"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1111\/ner.12018","article-title":"Epidemiology of low back pain in adults","volume":"17 Suppl 2","author":"Manchikanti L","year":"2014","unstructured":"Manchikanti L, Singh V, Falco FJ, Benyamin RM, Hirsch JA. Epidemiology of low back pain in adults. Neuromodulation. 2014, 17 Suppl 2:3-10. 10.1111\/ner.12018","journal-title":"Neuromodulation"},{"key":"ref3","doi-asserted-by":"crossref","DOI":"10.1097\/00003086-198606000-00008","article-title":"Posterolateral percutaneous suction-excision of herniated lumbar intervertebral discs. Report of interim results","volume":"207","author":"Kambin P","year":"1986","unstructured":"Kambin P, Sampson S. Posterolateral percutaneous suction-excision of herniated lumbar intervertebral discs. Report of interim results. Clin Orthop Relat Res. 1986, 207:37-43.","journal-title":"Clin Orthop Relat Res"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39223.428495.BE","article-title":"Diagnosis and treatment of sciatica","volume":"334","author":"Koes BW","year":"2007","unstructured":"Koes BW, van Tulder MW, Peul WC. Diagnosis and treatment of sciatica. BMJ. 2007, 334:1313-7. 10.1136\/bmj.39223.428495.BE","journal-title":"BMJ"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l6273","article-title":"Diagnosis and treatment of sciatica","volume":"367","author":"Jensen RK","year":"2019","unstructured":"Jensen RK, Kongsted A, Kjaer P, Koes B. Diagnosis and treatment of sciatica. BMJ. 2019, 367:l6273. 10.1136\/bmj.l6273","journal-title":"BMJ"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1177\/2192568220936217","article-title":"An assessment of nonoperative management strategies in a herniated lumbar disc population: successes versus failures","volume":"11","author":"Lilly DT","year":"2021","unstructured":"Lilly DT, Davison MA, Eldridge CM, Singh R, Montgomery EY, Bagley C, Adogwa O. An assessment of nonoperative management strategies in a herniated lumbar disc population: successes versus failures. Global Spine J. 2021, 11:1054-63. 10.1177\/2192568220936217","journal-title":"Global Spine J"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-020-06733-9","article-title":"Comparison of interlaminar CT-guided epidural platelet-rich plasma versus steroid injection in patients with lumbar radicular pain","volume":"30","author":"Bise S","year":"2020","unstructured":"Bise S, Dallaudiere B, Pesquer L, et al.. Comparison of interlaminar CT-guided epidural platelet-rich plasma versus steroid injection in patients with lumbar radicular pain. Eur Radiol. 2020, 30:3152-60. 10.1007\/s00330-020-06733-9","journal-title":"Eur Radiol"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1016\/j.jphys.2017.02.012","article-title":"Low back pain and sciatica in over 16s: assessment and management NICE Guideline [NG59]","volume":"63","author":"de Campos TF","year":"2017","unstructured":"de Campos TF. Low back pain and sciatica in over 16s: assessment and management NICE Guideline [NG59]. J Physiother. 2017, 63:120. 10.1016\/j.jphys.2017.02.012","journal-title":"J Physiother"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp1512658","article-title":"Herniated lumbar intervertebral disk","volume":"374","author":"Deyo RA","year":"2016","unstructured":"Deyo RA, Mirza SK. Herniated lumbar intervertebral disk. N Engl J Med. 2016, 374:1763-72. 10.1056\/NEJMcp1512658","journal-title":"N Engl J Med"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2013.08.003","article-title":"An evidence-based clinical guideline for the diagnosis and treatment of lumbar disc herniation with radiculopathy","volume":"14","author":"Kreiner DS","year":"2014","unstructured":"Kreiner DS, Hwang SW, Easa JE, et al.. An evidence-based clinical guideline for the diagnosis and treatment of lumbar disc herniation with radiculopathy. Spine J. 2014, 14:180-91. 10.1016\/j.spinee.2013.08.003","journal-title":"Spine J"},{"key":"ref11","doi-asserted-by":"crossref","DOI":"10.29252\/beat-070209","article-title":"Lumbar transforaminal epidural steroid injection in patients with lumbar radicular pain; outcome results of 2-year follow-up","volume":"7","author":"Hashemi M","year":"2019","unstructured":"Hashemi M, Dadkhah P, Taheri M, Ghasemi M, Hosseinpour A. Lumbar transforaminal epidural steroid injection in patients with lumbar radicular pain; outcome results of 2-year follow-up. Bull Emerg Trauma. 2019, 7:144-9.","journal-title":"Bull Emerg Trauma"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.12122\/j.issn.1673-4254.2020.12.16","article-title":"Lumbar transforaminal epidural block for treatment of low back pain with radicular pain (Article in Chinese)","volume":"40","author":"He Y","year":"2020","unstructured":"He Y, Chen L, Xu Z, Wang J, Liu B. Lumbar transforaminal epidural block for treatment of low back pain with radicular pain (Article in Chinese). Nan Fang Yi Ke Da Xue Xue Bao. 2020, 40:1804-9. 10.12122\/j.issn.1673-4254.2020.12.16","journal-title":"Nan Fang Yi Ke Da Xue Xue Bao"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1016\/S1529-9430(02)00560-0","article-title":"Lumbar epidural steroid injections","volume":"29","author":"Rivera CE","year":"2018","unstructured":"Rivera CE. Lumbar epidural steroid injections. Phys Med Rehabil Clin N Am. 2018, 29:73-92. 10.1016\/S1529-9430(02)00560-0","journal-title":"Phys Med Rehabil Clin N Am"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1177\/0284185118762248","article-title":"The retroneural approach: an alternative technique for lumbar transforaminal epidural steroid injections","volume":"59","author":"Ignjatovic S","year":"2018","unstructured":"Ignjatovic S, Omidi R, Kubik-Huch RA, Anderson S, Ahlhelm FJ. The retroneural approach: an alternative technique for lumbar transforaminal epidural steroid injections. Acta Radiol. 2018, 59:1508-16. 10.1177\/0284185118762248","journal-title":"Acta Radiol"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.5535%2Farm.2011.35.6.833","article-title":"Kambin\u2019s triangle approach of lumbar transforaminal epidural injection with spinal stenosis","volume":"35","author":"Park JW","year":"2011","unstructured":"Park JW, Nam HS, Cho SK, Jung HJ, Lee BJ, Park Y. Kambin\u2019s triangle approach of lumbar transforaminal epidural injection with spinal stenosis. Ann Rehabil Med. 2011, 35:833-43. 10.5535%2Farm.2011.35.6.833","journal-title":"Ann Rehabil Med"},{"key":"ref16","doi-asserted-by":"crossref","DOI":"10.2106\/00004623-197153050-00004","article-title":"Negative disc exploration. An analysis of the causes of nerve-root involvement in sixty-eight patients","volume":"53","author":"Macnab I","year":"1971","unstructured":"Macnab I. Negative disc exploration. An analysis of the causes of nerve-root involvement in sixty-eight patients. J Bone Joint Surg Am. 1971, 53:891-903.","journal-title":"J Bone Joint Surg Am"},{"key":"ref17","doi-asserted-by":"crossref","DOI":"10.1097\/00007632-198001000-00013","article-title":"Selective lumbosacral radiculography and block","volume":"5","author":"Tajima T","year":"1980","unstructured":"Tajima T, Furukawa K, Kuramochi E. Selective lumbosacral radiculography and block. Spine. 1980, 5:68-77.","journal-title":"Spine"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-011-2007-z","article-title":"Epidural steroid injections in the management of low-back pain with radiculopathy: an update of their efficacy and safety","volume":"21(2)","author":"Benoist M","year":"2012","unstructured":"Benoist M, Boulu P, Hayem G. Epidural steroid injections in the management of low-back pain with radiculopathy: an update of their efficacy and safety. Eur Spine J. 2012, 21(2):204-13. 10.1007\/s00586-011-2007-z","journal-title":"Eur Spine J"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.36076\/ppj.2012\/15\/E199","article-title":"Effectiveness of therapeutic lumbar transforaminal epidural steroid injections in managing lumbar spinal pain","volume":"3","author":"Manchikanti L","year":"2012","unstructured":"Manchikanti L, Buenaventura RM, Manchikanti KN, et al.. Effectiveness of therapeutic lumbar transforaminal epidural steroid injections in managing lumbar spinal pain. Pain Phys. 2012, 3:15. 10.36076\/ppj.2012\/15\/E199","journal-title":"Pain Phys"},{"key":"ref20","article-title":"Evaluation of lumbar transforaminal epidural injections with needle placement and contrast flow patterns: a prospective, descriptive report","volume":"7","author":"Manchikanti L","year":"2004","unstructured":"Manchikanti L, Cash KA, Pampati V, Damron KS, McManus CD. Evaluation of lumbar transforaminal epidural injections with needle placement and contrast flow patterns: a prospective, descriptive report. Pain Physician. 2004, 7:217-23.","journal-title":"Pain Physician"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1097\/00002060-200212000-00003","article-title":"Fluoroscopically guided lumbar transformational epidural steroid injections in degenerative lumbar stenosis: an outcome study","volume":"81","author":"Botwin KP","year":"2002","unstructured":"Botwin KP, Gruber RD, Bouchlas CG, et al.. Fluoroscopically guided lumbar transformational epidural steroid injections in degenerative lumbar stenosis: an outcome study. Am J Phys Med Rehabil. 2002, 81:898-905. 10.1097\/00002060-200212000-00003","journal-title":"Am J Phys Med Rehabil"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.3171\/foc.1998.5.3.2","article-title":"Microsurgical anatomy of the artery of Adamkiewicz and its segmental artery","volume":"89","author":"Alleyne Jr. CH","year":"1998","unstructured":"Alleyne Jr. CH, Cawley CM, Shengelaia GG, Barrow DL. Microsurgical anatomy of the artery of Adamkiewicz and its segmental artery. J Neurosurg. 1998, 89:791-5. 10.3171\/foc.1998.5.3.2","journal-title":"J Neurosurg"},{"key":"ref23","article-title":"Arthroscopic microdiscectomy: an alternative to open disc surgery","volume":"67","author":"Kambin P","year":"2000","unstructured":"Kambin P, Savitz MH. Arthroscopic microdiscectomy: an alternative to open disc surgery. Mt Sinai J Med. 2000, 67:283-7.","journal-title":"Mt Sinai J Med"},{"key":"ref24","article-title":"Paraplegia following a thoracolumbar transforaminal epidural steroid injection","volume":"8","author":"Glaser SE","year":"2005","unstructured":"Glaser SE, Falco F. Paraplegia following a thoracolumbar transforaminal epidural steroid injection. Pain Physician. 2005, 8:309-14.","journal-title":"Pain Physician"},{"key":"ref25","article-title":"Needle position analysis in cases of paralysis from transforaminal epidurals: consider alternative approaches to traditional technique","volume":"16","author":"Atluri S","year":"2013","unstructured":"Atluri S, Glaser SE, Shah RV, Sudarshan G. Needle position analysis in cases of paralysis from transforaminal epidurals: consider alternative approaches to traditional technique. Pain Physician. 2013, 16:321-4.","journal-title":"Pain Physician"},{"key":"ref26","article-title":"Comparison of the temporary diagnostic relief of transforaminal epidural steroid injection approaches: conventional versus posterolateral technique","volume":"28","author":"Lee IS","year":"2007","unstructured":"Lee IS, Kim SH, Lee JW. Comparison of the temporary diagnostic relief of transforaminal epidural steroid injection approaches: conventional versus posterolateral technique. AJNR. 2007, 28:204-8.","journal-title":"AJNR"},{"key":"ref27","article-title":"Root cause analysis of paraplegia following transforaminal epidural steroid injections: the \u2018unsafe\u2019 triangle","volume":"13","author":"Glaser SE","year":"2010","unstructured":"Glaser SE, Shah RV. Root cause analysis of paraplegia following transforaminal epidural steroid injections: the \u2018unsafe\u2019 triangle. Pain Physician. 2010, 13:237-44.","journal-title":"Pain Physician"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000209325.52986.da","article-title":"The diagnostic effect of various needle tip positions in selective lumbar nerve blocks: an analysis of 1202 injections","volume":"31","author":"Crall TS","year":"2006","unstructured":"Crall TS, Gilula LA, Kim YJ, Cho Y, Pilgram T, Riew KD. The diagnostic effect of various needle tip positions in selective lumbar nerve blocks: an analysis of 1202 injections. Spine (Phila Pa 1976). 2006, 31:920-2. 10.1097\/01.brs.0000209325.52986.da","journal-title":"Spine (Phila Pa 1976)"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.3348\/kjr.2006.7.2.139","article-title":"Transforaminal epidural steroid injection for lumbosacral radiculopathy: preganglionic versus conventional approach","volume":"7","author":"Lee JW","year":"2006","unstructured":"Lee JW, Kim SH, Choi JY, et al.. Transforaminal epidural steroid injection for lumbosacral radiculopathy: preganglionic versus conventional approach. Korean J Radiol. 2006, 7:139-44. 10.3348\/kjr.2006.7.2.139","journal-title":"Korean J Radiol"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2452062007","article-title":"Effectiveness of transforaminal epidural steroid injection by using a preganglionic approach: a prospective randomized controlled study","volume":"245","author":"Jeong HS","year":"2007","unstructured":"Jeong HS, Lee JW, Kim SH, Myung JS, Kim JH, Kang HS. Effectiveness of transforaminal epidural steroid injection by using a preganglionic approach: a prospective randomized controlled study. Radiology. 2007, 245:584-90. 10.1148\/radiol.2452062007","journal-title":"Radiology"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.5535\/arm.2011.35.6.833","article-title":"Kambin's triangle approach of lumbar transforaminal epidural injection with spinal stenosis","volume":"35","author":"Park JW","year":"2011","unstructured":"Park JW, Nam HS, Cho SK, Jung HJ, Lee BJ, Park Y. Kambin's triangle approach of lumbar transforaminal epidural injection with spinal stenosis. Ann Rehabil Med. 2011, 35:833-43. 10.5535\/arm.2011.35.6.833","journal-title":"Ann Rehabil Med"}],"container-title":["Cureus"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cureus.com\/articles\/187941-traditional-safe-triangle-approach-versus-kambins-triangle-approach-does-approach-really-matter-in-transforaminal-epidural-steroid-injection-tfesi-for-lumbar-disc-herniation","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,9]],"date-time":"2024-02-09T15:09:40Z","timestamp":1707491380000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cureus.com\/articles\/187941-traditional-safe-triangle-approach-versus-kambins-triangle-approach-does-approach-really-matter-in-transforaminal-epidural-steroid-injection-tfesi-for-lumbar-disc-herniation"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,12]]},"references-count":31,"URL":"https:\/\/doi.org\/10.7759\/cureus.48701","relation":{},"ISSN":["2168-8184"],"issn-type":[{"value":"2168-8184","type":"print"}],"subject":[],"published":{"date-parts":[[2023,11,12]]}}}