{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,4]],"date-time":"2025-10-04T10:10:29Z","timestamp":1759572629701,"version":"build-2065373602"},"reference-count":0,"publisher":"Indian Orthopaedic Research Group","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Jocr"],"published-print":{"date-parts":[[2025]]},"abstract":"<jats:p>Introduction: Lumbar prolapsed intervertebral disc (PIVD) is a prevalent cause of radicular pain and functional impairment. Epidural steroid injections are an established non-surgical treatment option. This study compares the efficacy of caudal, transforaminal, and interlaminar routes for methylprednisolone delivery.\n\nObjectives: To evaluate and compare the analgesic and functional outcomes of different ESI routes in managing lumbar PIVD.\n\nMaterials and Methods: In this prospective, randomized study, 75 patients aged 25\u201375 years with magnetic resonance imaging -confirmed single-level PIVD and refractory symptoms were allocated to one of three intervention groups: Caudal, transforaminal, or interlaminar ESI (n = 25 each). All patients received methylprednisolone acetate injections under fluoroscopic guidance. Pain and function were assessed using the Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) at baseline, 1, 2, and 4 weeks, and at 3 months post-intervention.\n\nResults: All groups showed significant reductions in VAS and ODI scores over time (P &lt; 0.001). At 3 months, the transforaminal group had the greatest improvement (VAS: 0.72 \u00b1 1.1; ODI: 2.92 \u00b1 4.61), followed by caudal and interlaminar routes. Analysis of variance and post hoc analysis confirmed the superiority of the transforaminal approach (P &lt; 0.001).\n\nConclusion: Transforaminal ESI with methylprednisolone provides superior pain relief and functional recovery compared to caudal and interlaminar routes. Route selection should consider anatomical precision and patient-specific factors.\n\nKeywords: Lumbar disc prolapse, epidural steroid injection, methylprednisolone, caudal, transforaminal, interlaminar, radiculopathy, Visual Analog Scale, Oswestry Disability Index, fluoroscopy.<\/jats:p>","DOI":"10.13107\/jocr.2025.v15.i10.6280","type":"journal-article","created":{"date-parts":[[2025,10,4]],"date-time":"2025-10-04T09:32:22Z","timestamp":1759570342000},"page":"441-449","source":"Crossref","is-referenced-by-count":0,"title":["Effectiveness of Epidural Methylprednisolone Injection in Management of Lumbar Prolapsed Intervertebral Disc: A Comparison of Caudal, Transforaminal and Interlaminar Routes"],"prefix":"10.13107","volume":"15","author":[{"name":"Department of Orthopaedics, SGT Medical College and Research Institute, Gurugram, Haryana, India.","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mrudul","family":"Kyada","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ketan","family":"Rupala","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Department of Orthopaedics, SGT Medical College and Research Institute, Gurugram, Haryana, India.","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akshay","family":"Bhatiya","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Department of Orthopaedics, SGT Medical College and Research Institute, Gurugram, Haryana, India.","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rahul","family":"Yadav","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Department of Orthopaedics, SGT Medical College and Research Institute, Gurugram, Haryana, India.","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naresh C","family":"Arora","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Department of Orthopaedics, SGT Medical College and Research Institute, Gurugram, Haryana, India.","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sansar Chand","family":"Sharma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Department of Orthopaedics, SGT Medical College and Research Institute, Gurugram, Haryana, India.","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"5271","published-online":{"date-parts":[[2025]]},"container-title":["Journal of Orthopaedic Case Reports"],"original-title":[],"deposited":{"date-parts":[[2025,10,4]],"date-time":"2025-10-04T09:32:22Z","timestamp":1759570342000},"score":1,"resource":{"primary":{"URL":"https:\/\/jocr.co.in\/wp\/2025\/10\/effectiveness-of-epidural-methylprednisolone-injection-in-management-of-lumbar-prolapsed-intervertebral-disc-a-comparison-of-caudal-transforaminal-and-interlaminar-routes\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025]]},"references-count":0,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2025]]},"published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.13107\/jocr.2025.v15.i10.6280","relation":{},"ISSN":["2321-3817"],"issn-type":[{"value":"2321-3817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025]]}}}