{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T15:26:05Z","timestamp":1787498765519,"version":"build-2736575974"},"reference-count":0,"publisher":"Indian Orthopaedic Research Group","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Jocr"],"published-print":{"date-parts":[[2025]]},"abstract":"<jats:p>Introduction: Epidural steroid injection (ESI) is one of the key management strategies in the management of discogenic radicular pain. This study aims to compare the efficacy and safety of fluoroscopy-guided ESI through caudal (cESI) and transforaminal (tfESI) routes for unilateral paracentral L5-S1 discogenic radicular pain.\n\nMaterials and Methods: This prospective non-randomized comparative study conducted between January 2023 and January 2024 in a tertiary care hospital included patients presenting with unilateral paracentral L5-S1 discogenic radicular pain who failed 6 weeks of conservative care. The pain and functional outcome was analyzed using numerical pain rating scale (NPRS) and Oswestry disability index, respectively, at baseline, 3-week, 6-week, and 6-month post-intervention. Procedure failure is defined as NPRS score improvement &lt;50% or ODI improvement &lt;40% of baseline. Other outcomes analyzed were the duration of the procedure, and fluoroscopy shots used during the procedure.\n\nResults: We enrolled 60 patients in the study, 54 patients were available till the final follow-up with 26 patients in the cESI group and 28 patients in the tfESI group. The mean age of the cESI group (M: F 12:14) and tfESI group (M:F 10:18) was 36.1 (\u00b14.1) years and 38.9 (\u00b13.9) years, respectively. The pain and functional scores were significantly reduced compared to the baseline scores in both the groups (P &lt; 0.001) and the reduction between the two groups was comparable at every follow-up. The tfESI group experienced significantly more failures (n = 8) at 6 months compared to the cESI group (n = 2) (P = 0.048). The tfESI group had significantly longer mean procedure time (18.8 min) and more fluoroscopy usage (16 shots) compared to cESI group with mean procedure time of 13 min (P = 0.014) and fluoroscopy usage of 10 shots (P = 0.023), respectively. No major adverse events were reported for either of the groups.\n\nConclusion: cESI is a simple, safe, and efficacious technique comparable to tfESI in the management of unilateral L5-S1 paracentral discogenic radicular pain with significantly less procedural time and fluoroscopy usage. Further, large-scale studies are needed to validate the study results.\n\nKeywords: Radicular pain, epidural steroid injection, caudal epidural, selective nerve root block, discogenic pain.<\/jats:p>","DOI":"10.13107\/jocr.2025.v15.i02.5296","type":"journal-article","created":{"date-parts":[[2025,2,7]],"date-time":"2025-02-07T05:40:30Z","timestamp":1738906830000},"page":"239-238","source":"Crossref","is-referenced-by-count":2,"title":["Comparative Efficacy and Safety of Fluoroscopy-guided Caudal Epidural Steroid Injection and Transforaminal Epidural Steroid Injection for Unilateral L5-S1 Paracentral Discogenic Radicular Pain"],"prefix":"10.13107","volume":"15","author":[{"name":"[1] Department of Orthopaedics, Government Medical College, Karur, Tamil Nadu, India, [2] Department of Orthopaedics, Orthopaedic Research Group, Coimbatore, Tamil Nadu, India, [3] Department of Biotechnology, Faculty of Engineering, Karpagam Academy of Higher Education, Coimbatore, Tamil Nadu, India.","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sathish","family":"Muthu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Praveen","family":"Thangavel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Department of Orthopaedics, Government Medical College, Karur, Tamil Nadu, India,","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sivaraman","family":"Duraisamy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Department of Orthopaedics, Government Medical College, Karur, Tamil Nadu, India,","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arun Anand","family":"Palaniappan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Department of Orthopaedics, Government Medical College, Karur, Tamil Nadu, India,","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"5271","published-online":{"date-parts":[[2025]]},"container-title":["Journal of Orthopaedic Case Reports"],"original-title":[],"deposited":{"date-parts":[[2025,2,7]],"date-time":"2025-02-07T05:40:38Z","timestamp":1738906838000},"score":1,"resource":{"primary":{"URL":"https:\/\/jocr.co.in\/wp\/2025\/02\/01\/comparative-efficacy-and-safety-of-fluoroscopy-guided-caudal-epidural-steroid-injection-and-transforaminal-epidural-steroid-injection-for-unilateral-l5-s1-paracentral-discogenic-radicular-pain\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025]]},"references-count":0,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2025]]},"published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.13107\/jocr.2025.v15.i02.5296","relation":{},"ISSN":["2321-3817"],"issn-type":[{"value":"2321-3817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025]]}}}