{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T21:56:05Z","timestamp":1792706165395,"version":"4.5.0"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"Suppl 6","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,10]]},"abstract":"\n Background and Aims:<\/jats:title>\n Epidural steroid injections (ESIs) with or without local anaesthetics have been used for the past several years for the treatment of back pain, especially for radicular symptoms. The aim of this prospective study was to compare the efficacy of midline with parasagittal approach for interlaminar ESI in the management of symptomatic lumbar intervertebral disc herniation.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n \n Sixty patients (aged 20\u201360 years) with pain pattern consistent with lumbar radiculopathy caused by lumbar intervertebral disc herniation and who did not respond to conservative treatment were included in the study. They were randomly divided in two groups of 30 each: group I (MILESI,\n n<\/jats:italic>\n = 30) consisting of midline interlaminar ESI, and group II (PSILESI,\n n<\/jats:italic>\n = 30) consisting of parasagittal interlaminar ESI. They were administered a combination of 80 mg of methylprednisolone acetate (40 mg\/ml) and 6 ml of 0.25% bupivacaine (total volume of 8 ml). Pain, patient satisfaction, and the Oswestry Disability Index (ODI) were assessed at different time intervals before and after the procedure for up to six months.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n The improvement in pain score after ESI was statistically significant in both the groups at all intervals of time, with no significant difference between the two groups. The mean pain score was <3 from two weeks onwards after the injection. The pain score decreased by more than five points and it was around two points at the end of the six-month study period. Around 50% of patients in both groups had excellent satisfaction.<\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Both techniques were effective in providing good analgesia. Pain relief and improvement in disability were clinically better with the parasagittal interlaminar approach.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/ija.ija_349_22","type":"journal-article","created":{"date-parts":[[2022,10,11]],"date-time":"2022-10-11T06:53:57Z","timestamp":1665471237000},"page":"S314-S319","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":7,"title":["Comparative evaluation of midline versus parasagittal interlaminar epidural steroid injection for management of symptomatic lumbar intervertebral disc herniation"],"prefix":"10.4103","volume":"66","author":[{"given":"Amit","family":"Kumar","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology, Pt. B. D. Sharma PGIMS, Rohtak, Haryana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naveen","family":"Malhotra","sequence":"additional","affiliation":[{"name":"Department of Cardiac Anaesthesiology and Pain Mangement Centre, Pt. B. D. Sharma PGIMS, Rohtak, Haryana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"family":"Aditi","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Pt. B. D. Sharma PGIMS, Rohtak, Haryana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"family":"Jyotsna","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Pt. B. D. Sharma PGIMS, Rohtak, Haryana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"family":"Anshul","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Pt. B. D. Sharma PGIMS, Rohtak, Haryana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Disha","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Pt. B. D. Sharma PGIMS, Rohtak, Haryana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2022,10,12]]},"reference":[{"key":"B1-20240902","doi-asserted-by":"crossref","first-page":"185","DOI":"10.36076\/ppj.2007\/10\/185","article-title":"Epidural steroids in the management of chronic spinal pain:A systematic review","volume":"10","author":"Abdi","year":"2007","journal-title":"Pain Physician"},{"key":"B2-20240902","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1213\/00000539-200208000-00031","article-title":"The technical aspects of epidural steroid injections:A national survey","volume":"95","author":"Cluff","year":"2002","journal-title":"Anesth Analg"},{"key":"B3-20240902","doi-asserted-by":"crossref","first-page":"738","DOI":"10.1148\/radiol.2372041406","article-title":"Lumbar radiculopathy:Treatment with selective lumbar nerve blocks-comparison of effectiveness of triamcinolone and betamethasone injectable suspensions","volume":"237","author":"Blankenbaker","year":"2005","journal-title":"Radiology"},{"key":"B4-20240902","doi-asserted-by":"crossref","first-page":"322","DOI":"10.36076\/ppj.2001\/4\/322","article-title":"Caudal epidural injections with steroid in chronic low back pain","volume":"4","author":"Manchikanti","year":"2001","journal-title":"Pain Physician"},{"key":"B5-20240902","doi-asserted-by":"crossref","first-page":"785","DOI":"10.36076\/ppj.2008\/11\/785","article-title":"Preliminary results of randomized equivalence trial of fluoroscopic caudal epidural injections in managing chronic low back pain:Discogenic pain without disc herniation or radiculitis","volume":"11","author":"Manchikanti","year":"2008","journal-title":"Pain Physician"},{"key":"B6-20240902","doi-asserted-by":"crossref","first-page":"77","DOI":"10.36076\/ppj.2004\/7\/77","article-title":"Fluoroscopic guided lumbar interlaminar epidural injections:A prospective evaluation of epidurography contrast patterns and anatomical review of the epidural space","volume":"7","author":"Botwin","year":"2004","journal-title":"Pain Physician"},{"key":"B7-20240902","doi-asserted-by":"crossref","first-page":"163","DOI":"10.36076\/ppj.2009\/12\/163","article-title":"Lumbar interlaminar epidural injections in managing chronic low back and lower extremity pain:A systematic review","volume":"12","author":"Parr","year":"2009","journal-title":"Pain Physician"},{"key":"B8-20240902","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1213\/ANE.0b013e3182910a15","article-title":"Lateral parasagittal versus midline interlaminar lumbar epidural steroid injection for management of low back pain with lumbosacral radicular pain:A double-blind, randomized study","volume":"117","author":"Ghai","year":"2013","journal-title":"Anesth Analg"},{"key":"B9-20240902","doi-asserted-by":"crossref","first-page":"2940","DOI":"10.1097\/00007632-200011150-00017","article-title":"The oswestry disability index","volume":"25","author":"Fairbank","year":"2000","journal-title":"Spine"},{"key":"B10-20240902","first-page":"26","article-title":"Efficacy of fluoroscopically guided, contrast-enhanced lumbosacral interlaminar epidural steroid injections","volume":"9","author":"Furman","year":"2010","journal-title":"Pain Med"},{"key":"B11-20240902","first-page":"361","article-title":"Interlaminar versus transforaminal epidural injections for treatment of symptomatic lumbar intervertebral disc herniation","volume":"9","author":"Schaufele","year":"2006","journal-title":"Pain Physician"},{"key":"B12-20240902","doi-asserted-by":"crossref","first-page":"343","DOI":"10.36076\/ppj.2010\/13\/343","article-title":"Evaluation of the effectiveness of lumbar interlaminar epidural injections in managing chronic pain of lumbar disc herniation or radiculitis:A randomized, double-blind, controlled trial","volume":"13","author":"Manchikanti","year":"2010","journal-title":"Pain Physician"},{"key":"B13-20240902","doi-asserted-by":"crossref","first-page":"499","DOI":"10.36076\/ppj.2011\/14\/499","article-title":"Interlaminar versus transforaminal epidural steroids for the treatment of subacute lumbar radicular pain: A randomized, blinded, prospective outcome study","volume":"14","author":"Gharibo","year":"2011","journal-title":"Pain Physician"},{"key":"B14-20240902","first-page":"1","article-title":"Comparison of transforaminal and interlaminar epidural steroid injections for the treatment of chronic lumbar pain","volume":"6","author":"Beyaz","year":"2016","journal-title":"Rev Bras Anestesiol"},{"key":"B15-20240902","doi-asserted-by":"crossref","first-page":"599","DOI":"10.4103\/sja.SJA_263_18","article-title":"A comparative study between interlaminar nerve root targeted epidural versus infraneural transforaminal epidural steroids for treatment of intervertebral disc herniation","volume":"12","author":"Maadawy","year":"2018","journal-title":"Saudi J Anaesth"}],"container-title":["Indian Journal of Anaesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ija.ija_349_22","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T15:10:57Z","timestamp":1787757057000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ija.ija_349_22"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10]]},"references-count":15,"journal-issue":{"issue":"Suppl 6","published-print":{"date-parts":[[2022]]}},"URL":"https:\/\/doi.org\/10.4103\/ija.ija_349_22","relation":{},"ISSN":["0019-5049","0976-2817"],"issn-type":[{"value":"0019-5049","type":"print"},{"value":"0976-2817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10]]},"assertion":[{"value":"2022-04-21","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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