RESUMO
Objective: to find out the effectiveness of interlaminar parasagittal lumbar epidural injection without using flouroscopy in the management of low back pain with radiculopathy
Study design: descriptive case series
Place and Duration of study: Ziauddin University Hospital Karachi Clifton campus, from January 2013 to December 2014
Methodology: patients with lumbar back pain associated with unilateral sciatica for more than three months duration were included. Visual analogue scale [VAS] of 100 was used for pain severity assessment. Lumbosacral spine x-rays with skin surface marking were obtained before the procedure. Interlaminar parasagittal approach was used in lateral position with affected leg up. Follow up was done at 6 weeks, 3 months, and 6 months. During the course of 6 months, three injections were offered at any point of recurrence of pain with at least 2 to 3 weeks interval
Results: a total of 75 patients of both genders with the mean age of 45.03 +/- 14.35 year were included. Disc levels involved were L4/5 [53.33%], L5/S1 [38.66%], and L3/4 [8%]. Pre-procedural mean VAS score was 75.2 +/-15.99. In 65.33% patients sustained significant relief in pain noted at six months follow up. In 20% patients short term recovery observed with recurrence of pain in three months. No major complication was encountered during the procedure
Conclusion: interlaminar parasagittal epidural injection is simple, effective in relieving chronic low back pain associated with sciatica and does not need any special medical equipments and setup