Comparison of the efficacy of caudal, interlaminar, and transforaminal epidural injections in managing XXXX : is one method superior to the other?

@entity1 @entity134 @entity158 @entity230 @entity1118 @entity890
BACKGROUND: Epidural injections are performed utilizing 3 approaches in the lumbar spine: caudal, interlaminar, and transforaminal. The literature on the efficacy of epidural injections has been sporadic. There are few high-quality randomized trials performed under fluoroscopy in managing disc herniation that have a long-term follow-up and appropriate outcome parameters. There is also a lack of literature comparing the efficacy of these 3 approaches. METHODS: This manuscript analyzes data from 3 randomized controlled trials that assessed a total of 360 @entity1 with @entity890 . There were 120 @entity1 per trial either receiving local anesthetic alone (60 @entity1 ) or local anesthetic with @entity230 (60 @entity1 ). RESULTS: Analysis showed similar efficacy for caudal, interlaminar, and transforaminal approaches in managing @entity1118 and disability from disc herniation. The analysis of caudal epidural injections showed the potential superiority of @entity230 compared with local anesthetic alone a 2-year follow-up, based on the average relief per procedure. In the interlaminar group, results were somewhat superior for @entity158 relief in the @entity134 group at 6 months and functional status at 12 months. Interlaminar epidurals provided improvement in a significantly higher proportion of @entity1 . The proportion of @entity1 nonresponsive to initial injections was also lower in the group for local anesthetic with @entity134 in the interlaminar trial. CONCLUSIONS: The results of this assessment show significant improvement in @entity1 suffering from @entity890 with 3 lumbar epidural approaches with local anesthetic alone, or using @entity230 with long-term follow-up of up to 2 years, in a contemporary interventional @entity158 management setting.
