In many cases, vertebral fractures can be treated through conservative methods such as bed rest, a back brace or pain medication. However, patients with osteoporosis or whose fractures have caused severe, long-term pain may benefit from a minimally invasive procedure such as vertebroplasty to relieve symptoms. This procedure is also recommended for patients who are too weak to undergo spinal surgery, or have a malignant tumor within the spine that has caused vertebral damage. Vertebroplasty is most effective when performed on fractures that are less than six months old.
There is fair evidence supporting TFESIs as superior to placebo for treating radicular symptoms. There is good evidence that TFESIs should be used as a surgery-sparing intervention, and that TFESIs are superior to interlaminar ESIs (ILESIs) and caudal ESIs for radicular pain. In patients with subacute or chronic radicular symptoms, there is good evidence that a single TFESI has similar efficacy as a single transforaminal injection of bupivacaine or saline. Future studies should address the ideal number of injections. While more placebo-controlled trials are needed to conclusively define the role of TFESIs, current studies support their use in the treatment of lumbosacral radicular pain.