Premium
Spinal endoscopy in chronic low back pain with radiculopathy A prospective case series
Author(s) -
Richardson J.,
McGurgan P.,
Cheema S.,
Prasad R.,
Gupta S.
Publication year - 2001
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1046/j.1365-2044.2001.01524-3.x
Subject(s) - medicine , endoscopy , surgery , prospective cohort study , bupivacaine , low back pain , nerve root , back pain , anesthesia , pathology , alternative medicine
All 38 patients listed for day‐case spinal endoscopy over a 12‐month period (April 1998 – April 1999), who had chronic severe low back pain with a radiculopathic element, were studied prospectively. The mean [range] pain duration before treatment was 10.9 [2–26] years and 50% had failed back surgery syndrome. In all patients in whom treatment was completed ( n = 34), the pain‐generating nerve roots were located through symptom interaction with the patient. All had epidural scar tissue, 14 (41%) having dense adhesions. Mobilisation of adhesions around the nerve root (neuroplasty) was performed so that a pocket was formed for the subsequent placement of bupivacaine, Depomedrone and clonidine. No intra‐operative complications occurred and side‐effects were minimal. Follow‐up over a 12‐month period showed statistically significant reductions in pain scores and disability. Spinal endoscopy may be the diagnostic method of choice for epidural fibrosis. It has substantial therapeutic and research potential. Prospective randomised studies are required.