Evaluating Bilateral Symptom Relief Following Parasagittal Interlaminar Epidural Steroid Injections

Area of Science:

• Pain Management
• Neurosurgery
• Radiology

Background:

• Interlaminar epidural steroid injections (ILESIs) are common for lumbar radicular pain.
• The effectiveness of parasagittal ILESIs for contralateral pain relief is not well understood.

Purpose of the Study:

• To assess the short-term efficacy of parasagittal ILESIs in alleviating both ipsilateral and contralateral symptoms.
• To evaluate symptom relief in patients with bilateral lumbar radiculopathy and unilateral contrast spread.

Main Methods:

• Retrospective review of 12 patients with bilateral lumbar radicular symptoms.
• Parasagittal ILESIs performed under fluoroscopic guidance.
• Assessment of patient-reported symptom relief at two weeks (ipsilateral and contralateral).

Main Results:

• Significant ipsilateral symptom relief (mean 84.6%, range 60-100%).
• Variable contralateral relief (mean 37.5%, range 0-90%).
• No reported complications.

Conclusions:

• Parasagittal ILESIs are highly effective for ipsilateral pain.
• Contralateral relief is inconsistent and may depend on injection technique and medication spread.
• Consider midline ILESIs or bilateral transforaminal injections for significant bilateral symptoms.