The Impact on Fluoroscopic Image Review on Patient Satisfaction and Perceived Improvement Following Lumbosacral Epidural Steroid Injection
Tahsin Choudury DO1, John Jung, MD,1 SriKrishna Chandran MD1, Monica Barnes DO1, James Eckner MD1, Micheal Geisser PhD1, David J. Kohns, DO1
1 = University of Michigan
Introduction:
•Interventional spine and pain physicians rarely review fluoroscopic images with patients after procedures.
•Patient satisfaction is already high, but there may be ways to further improve the patient experience.
•This study examined the impact of post-procedure fluoroscopic image review on perceived benefit of image review and patient satisfaction.
Material and Methods:
•Single blinded prospective study of patients undergoing non-sedation lumbosacral TFESIs.
•The control group received a scripted verbal explanation of procedure results.
•The intervention group received the same explanation including a review of fluoroscopic images.
•Outcomes measured: Perceived benefit of image review questions and modified Press Ganey Patient Satisfaction Survey administered immediately post-procedure.
•Short-term improvement assessed at two weeks using the Patient Global Impression of Change (PGIC); missing data supplemented with chart review.
•Group responses compared using appropriate statistical tests.
Results:
•141 participants enrolled: 70 control, 71 intervention.
•Follow-up improvement data available for 58 participants in each group (82%).
•95.8% of the intervention group found image review helpful to very helpful.
•68.6% of the control group thought image review would have been helpful to very helpful.
•Confidence in provider was significantly higher in the intervention group (p = 0.03).
•No significant differences in short-term improvement between groups.
Discussions:
•Consistent with prior studies, both groups reported high overall satisfaction.
•95.8% of the image review group found it helpful, compared to 68.6% of the control group who thought it would have been helpful.
•Image review significantly increased confidence in the provider. No differences were observed in other satisfaction domains or short-term improvement.
•Limitations of this include single-center design, uneven proceduralist distribution, potential response bias, difference in perceived benefit questions, and low follow-up on PGIC.
•Future studies may explore how image review impacts patient education, procedural fear, and provider-patient trust.
Conclusion:
•Post-procedure image review is appreciated by patients and increases confidence in providers.
•Image review is a short and simple act that appears to improve the patient experience with interventional spine procedures
References:
1.Rekatsina M, Peng PWH. The Importance of Image Guidance in Common Spine Interventional Procedures for Pain Management: A Comprehensive Narrative Review. Pain Ther. 2025;14(3):841-863. doi:10.1007/s40122-025-00731-9
2.Langford DJ, Mark RP, France FO, et al. Use of patient-reported global assessment measures in clinical trials of chronic pain treatments: ACTTION systematic review and considerations. Pain. 2024;165(11):2445-2454. doi:10.1097/j.pain.0000000000003270
