Clinical effectiveness and prognostic indicators of parasagittal interlaminar epidural injection

Background: interlaminar epidural steroid injection (esi) is a well-established intervention to improve radicular leg pain. however,few studies have demonstrated the prognostic factors for interlaminar esi. objective: to investigate the clinical effectiveness and prognostic indicators of parasagittal interlaminar esi during a 2-week follow-up. study design: prospective evaluation. setting: an interventional pain management practice in south korea. methods: after institutional review board approval,parasagittal interlaminar esi under fluoroscopic guidance was performed in 55 patients with central spinal stenosis. the numerical rating scale (nrs) and the oswestry disability index (odi) (%) were used to evaluate clinical efficacy and prognostic indicators. to determine the prognostic indicators,treatment outcomes were classified as successful (decreased nrs ≥ 50%,decreased odi ≥ 40%) and unsuccessful (decreased nrs < 50%,decreased odi < 40%) results. results: parasagittal interlaminar esi significantly improved the nrs and odi (%) scores after 2 weeks compared to those measured pretreatment. paresthesia provocation (p = 0.006) was a significant prognostic factor on the nrs,whereas the beck depression inventory (bdi) score (p = 0.007),paresthesia provocation (p = 0.035),and epidurography finding (p = 0.038) were significant on the odi (%) score between patients with successful and unsuccessful outcomes. limitations: we included the method of parasagittal interlaminar esi only,therefore,direct comparison with other techniques was not available. conclusion: parasagittal interlaminar esi significantly improved the nrs and odi (%) scores. paresthesia provocation was a prognostic indicator on the nrs and odi (%) scores,and bdi scores and epidurography findings were prognostic indicators for the odi (%) score. © 2016,american society of interventional pain physicians. all rights reserved.