Tariq Muhammad, Mukesh Kumar, Imtiaz Ahmad Hashmi, Myounis Khatri.
Lumbar Interlaminar Epidural Injections in Managing Chronic Low Back Pain with Sciatica Without Using Fluoroscopy.
J Surg Pak Jan ;21(2):45-8.

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 & 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: nterlaminar 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.

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