Scindapsus officinalis (S. officinalis) holds a reputed position in Ayurvedic system of medicine. It has been ethanobotanically used to treat diarrhea (“atisara”), worm infes-tation (“krmiroga”), and as antipyretic. Literature survey on S. officinalis was carried out via electronic search in PubMed, SciFinder, Scirus, Google Scholar, Agricola and Web of Science and a library search. Results revealed that a very specific botanical description of the plant is still not available. The plant is mistaken within the hybrids and other plants of genus Scindapsus and family Araceae. Since ethnobotanically the plant is of much importance, chemistry of the plant yet needs to be fully explored. Thus the need of the hour is to comprehend the fragmented information available on the botany, traditional uses, phytochemistry and pharmacology of S. officinalis which could help in the correct identification of the sample and avoid adulteration due to mistaken identity.

BACKGROUND: Epidural steroid injections are an accepted procedure for the conservative management of chronic backache caused by lumbar disc pathology. The purpose of this study was to evaluate the epidurographic findings for the midline, transforaminal and parasagittal approaches in lumbar epidural steroid injections, and correlating them with the clinical improvement. METHODS: Sixty chronic lower back pain patients with unilateral radiculitis from a herniated/degenerated disc were enrolled. After screening the patients according to the exclusion criteria and randomly allocating them to 3 groups of 20 patients, fluoroscopic contrast enhanced epidural steroids were injected via midline (group 1), transforaminal (group 2) and parasagittal interlaminar (group 3) approaches at the level of the pathology. The fluoroscopic patterns of the three groups were studied and correlated with the clinical improvement measured by the VAS over the next 3 months; any incidences of complications were recorded. RESULTS: The transforaminal group presented better results in terms of VAS reduction than the midline and parasagittal approach groups (P < 0.05). The epidurography showed a better ventral spread for both the transforaminal (P < 0.001) and the paramedian approaches (P < 0.05), as compared to the midline approach. The nerve root filling was greater in the transforaminal group (P < 0.001) than in the other two groups. The ventral spread of the contrast agent was associated with improvement in the VAS score and this difference was statistically significant in group 1 (P < 0.05), and highly significant in groups 2 and 3 (P < 0.001). In all the groups, any complications observed were transient and minor. CONCLUSIONS: The midline and paramedian approaches are technically easier and statistically comparable, but clinically less efficacious than the transforaminal approach. The incidence of ventral spread and nerve root delineation show a definite correlation with clinical improvement. However, an longer follow-up period is advisable for a better evaluation of the actual outcom.
Back Pain ; Fluoroscopy ; Follow-Up Studies ; Humans ; Incidence ; Low Back Pain ; Mass Screening ; Pathology ; Radiculopathy ; Steroids

BACKGROUND: Epidural steroid injections are an accepted procedure for the conservative management of chronic backache caused by lumbar disc pathology. The purpose of this study was to evaluate the epidurographic findings for the midline, transforaminal and parasagittal approaches in lumbar epidural steroid injections, and correlating them with the clinical improvement. METHODS: Sixty chronic lower back pain patients with unilateral radiculitis from a herniated/degenerated disc were enrolled. After screening the patients according to the exclusion criteria and randomly allocating them to 3 groups of 20 patients, fluoroscopic contrast enhanced epidural steroids were injected via midline (group 1), transforaminal (group 2) and parasagittal interlaminar (group 3) approaches at the level of the pathology. The fluoroscopic patterns of the three groups were studied and correlated with the clinical improvement measured by the VAS over the next 3 months; any incidences of complications were recorded. RESULTS: The transforaminal group presented better results in terms of VAS reduction than the midline and parasagittal approach groups (P < 0.05). The epidurography showed a better ventral spread for both the transforaminal (P < 0.001) and the paramedian approaches (P < 0.05), as compared to the midline approach. The nerve root filling was greater in the transforaminal group (P < 0.001) than in the other two groups. The ventral spread of the contrast agent was associated with improvement in the VAS score and this difference was statistically significant in group 1 (P < 0.05), and highly significant in groups 2 and 3 (P < 0.001). In all the groups, any complications observed were transient and minor. CONCLUSIONS: The midline and paramedian approaches are technically easier and statistically comparable, but clinically less efficacious than the transforaminal approach. The incidence of ventral spread and nerve root delineation show a definite correlation with clinical improvement. However, an longer follow-up period is advisable for a better evaluation of the actual outcom.
Back Pain ; Fluoroscopy ; Follow-Up Studies ; Humans ; Incidence ; Low Back Pain ; Mass Screening ; Pathology ; Radiculopathy ; Steroids

Scindapsus officinalis (S. officinalis) holds a reputed position in Ayurvedic system of medicine. It has been ethanobotanically used to treat diarrhea (“atisara”), worm infestation (“krmiroga”), and as antipyretic. Literature survey on S. officinalis was carried out via electronic search in PubMed, SciFinder, Scirus, Google Scholar, Agricola and Web of Science and a library search. Results revealed that a very specific botanical description of the plant is still not available. The plant is mistaken within the hybrids and other plants of genus Scindapsus and family Araceae. Since ethnobotanically the plant is of much importance, chemistry of the plant yet needs to be fully explored. Thus the need of the hour is to comprehend the fragmented information available on the botany, traditional uses, phytochemistry and pharmacology of S. officinalis which could help in the correct identification of the sample and avoid adulteration due to mistaken identity.