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Spinal endoscopy in chronic low back pain with radiculopathy. (Bradford Royal Infirmary, Bradford, United Kingdom) Anaesthesia 2001;56:454–460.
Author(s) -
Richardson J.,
McGurgan P.,
Cheema S.,
Prasad R.,
Gupta S.
Publication year - 2001
Publication title -
pain practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 58
eISSN - 1533-2500
pISSN - 1530-7085
DOI - 10.1046/j.1533-2500.2001.1039_3.x
Subject(s) - medicine , endoscopy , bupivacaine , anesthesia , surgery , nerve root , spinal anesthesia , back pain , chronic pain , physical therapy , alternative medicine , pathology
All 38 patients listed for day‐case spinal endoscopy over a 12‐month period, who had chronic severe low back pain with a radiculopathic element, were studied. The mean pain duration before treatment was 10.9 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 adhesion. Mobilization of adhesions around the nerve root 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 randomized studies are required.