Corpus ID: 41553553

Concordant provocation as a prognostic indicator during interlaminar lumbosacral epidural steroid injections.

  title={Concordant provocation as a prognostic indicator during interlaminar lumbosacral epidural steroid injections.},
  author={Alexander H Sinofsky and Steve M. Aydin and Eric Kim and Christopher G. Gharibo},
  journal={Pain physician},
  volume={17 3},
BACKGROUND Interlaminar epidural steroid injection is a well-established intervention for the treatment of radicular pain. Pain is commonly reported during the injection into the epidural space; this provocation is typically either concordant or discordant with the patient's baseline pain. It is not well known how this provocation pain relates to treatment outcomes. OBJECTIVE To determine the relationship between concordant versus discordant provocation during interlaminar epidural steroid… Expand
Concordant pain provocation during transforaminal epidural steroid injection for lumbosacral radiculopathy: effect on pain outcome and predictive factors.
Provocation of concordant radicular pain does not predict pain relief at short-term follow-up after a transforaminal ESI, and foraminal stenosis, nerve root impingement, and lack of a medial-superior contrast flow pattern are associated with pain during the transfor AMSI. Expand
Clinical Effectiveness and Prognostic Indicators of Parasagittal Interlaminar Epidural Injection.
Parasagittal interlaminar ESI significantly improved the NRS and ODI scores after 2 weeks compared to those measured pretreatment and prognostic indicators, and was a prognostic indicator for the ODI (%) score. Expand
Comparison of clinical efficacy in epidural steroid injections through transforaminal or parasagittal approaches
ESI under fluoroscopic guidance with PIL or TF approach were effective in reducing the NRS and ODI and PIL ESI was a technically easier and simple method compared to TF ESI. Expand
No difference in pain reduction after epidural steroid injections in diabetic versus nondiabetic patients: A retrospective cohort study
There was no difference in pain reduction after ESIs comparing diabetic with nondiabetic patients; however, for diabetic patients, pain reduction may decrease with uncontrolled diabetes determined by high HbA1c values, suggesting pain physicians to take an active role in guiding their patients to have their blood glucose levels better regulated to improve outcomes of their ESIs. Expand
Lumbar Epidural Steroid Injections.
  • Carlos E. Rivera
  • Medicine
  • Physical medicine and rehabilitation clinics of North America
  • 2018
The indications, evidence, and safety considerations for 2 different techniques-namely, interlaminar and transforaminal-are discussed. Expand


Concordant pressure paresthesia during interlaminar lumbar epidural steroid injections correlates with pain relief in patients with unilateral radicular pain.
This study showed that the lateral parasagittal interlaminar approach was more effective in targeting low back pain with unilateral radicular pain secondary to degenerative lumbar disc disease and showed that pressure paresthesia occurring ipsilaterally during an LESI correlates with pain relief and may be used as a prognostic factor. Expand
Interlaminar versus transforaminal epidural steroids for the treatment of subacute lumbar radicular pain: a randomized, blinded, prospective outcome study.
Results suggest that patients may experience greater subjective relief, at least initially, from TF epidural steroid injections over IL, however, more objective, and likely subacute, therapeutic effects are similar. Expand
The value of the provocation response in lumbar zygapophyseal joint injections.
This study calls into question the validity of pain provocation alone as a criterion standard in patients undergoing diagnostic lumbar zygapophyseal joint blocks. Expand
The Efficacy of Lumbar Epidural Steroid Injections in Patients with Lumbar Disc Herniations
The TF route of epidural steroid placement is more effective than the C or IL routes, due to a higher incidence of steroid placement in the ventral epidural space when the TF method is used. Expand
Comparison of effectiveness according to different approaches of epidural steroid injection in lumbosacral herniated disk and spinal stenosis.
Translaminar and transforaminal approach were more effective than caudal approach in HIVD and SS groups and especially, effectiveness of transfor aminal approach was more prominent in SS group as compared with HIVD group. Expand
A Prospective Evaluation of Iodinated Contrast Flow Patterns with Fluoroscopically Guided Lumbar Epidural Steroid Injections: The Lateral Parasagittal Interlaminar Epidural Approach Versus the Transforaminal Epidural Approach
The PIL approach is superior to the TF approach for placing contrast into the anterior epidural space with reduction in fluoroscopy times and an improved spread grade. Expand
Epidural corticosteroid injections for sciatica due to herniated nucleus pulposus.
Although epidural injections of methylprednisolone acetate may afford short-term improvement in leg pain and sensory deficits in patients with sciatica due to a herniated nucleus pulposus, this treatment offers no significant functional benefit, nor does it reduce the need for surgery. Expand
Pain reproduction during lumbosacral transforaminal epidural steroid injection does not affect outcome
There is no data available to support the supposition that the reproduction of a patient’s usual pain during ESI was of prognostic value as to which patients would show favorable results from the procedure, however, there is no evidence to support this supposition. Expand
Effect of fluoroscopically guided caudal epidural steroid or local anesthetic injections in the treatment of lumbar disc herniation and radiculitis: a randomized, controlled, double blind trial with a two-year follow-up.
Caudal epidural injections of local anesthetic with or without steroids might be an effective therapy for patients with disc herniation or radiculitis at two year follow up based on average relief per procedure. Expand
A multicentre randomized controlled trial of epidural corticosteroid injections for sciatica: the WEST study.
In this pragmatic study, ESIs offered transient benefit in symptoms at 3 weeks in patients with sciatica, but no sustained benefits in terms of pain, function or need for surgery. Expand