Recovery of H-Reflex with Transforaminal Epidural Steroid Injection in S1 Radiculopathy.

Transforaminal epidural steroid injection (TFESI) is a recognized nonsurgical management of radicular back pain through its effects on neural inflammation and edema [1]. Electrodiagnostic changes of the compressed nerve root such as Hoffmann reflex (H-reflex) are apparent within days following injury and persist throughout nerve compression [2], with sensitivity and specificity of 50% and 91%, respectively, making the detection of H-reflex abnormality an option to identify early radiculopathy [3]. Despite its prevalent diagnostic use, to our knowledge there is limited information in the current literature regarding changes of an abnormal H-reflex following treatment of radiculopathy. We have investigated the changes of the H-reflex profile following fluoroscopyguided epidural steroid injections in three patients with S1 radiculopathy secondary to disc herniation.