Korean J Pain.  2018 Apr;31(2):109-115. 10.3344/kjp.2018.31.2.109.

The outcome of epiduroscopy treatment in patients with chronic low back pain and radicular pain, operated or non-operated for lumbar disc herniation: a retrospective study in 88 patients

• Hazer DB
• AcarbaÅŸ A
• Rosberg HE

• KMID: 2410833
• DOI: http://doi.org/10.3344/kjp.2018.31.2.109

Abstract

BACKGROUND
Patients with lumbar disc herniation are treated with physiotherapy/medication and some with surgery. However, even after technically successful surgery some develop a failed back syndrome with persistent pain. Our aim was to evaluate the efficacy of epiduroscopy in patients who suffer chronic low back pain and/or radicular pain with or without surgery and the gender difference in outcome.
METHODS
A total of 88 patients were included with a mean age of 52 years (27-82), 54 women and 34 men. 66 of them were operated previously and 22 were non-operated. They all had persistent chronic back pain and radicular pain despite of medication and physical rehabilitation. Visual Analog Scale (VAS) for pain and Oswestry Disability Index (ODI) were evaluated preoperatively, after one month, six months and one-year after the epiduroscopy.
RESULTS
All patients, and also the subgroups (gender and operated/non-operated) improved significantly in pain (VAS) and disability (ODI) at one month. A significant improvement was also seen at one year. No differences were found between men and woman at the different follow-up times. A slight worsening in VAS and ODI was noticed over time except for the non-operated group.
CONCLUSIONS
Epiduroscopy helps to improve the back and leg pain due to lumbar disc herniation in the early stage. At one year an improvement still exists, and the non-operated group seems to benefit most of the procedure.

Keyword

Disability evaluation; Endoscopy; Epidural space; Intervertebral disc displacement; Low back pain; Pain measurement; Radiating pain; Sex; Surgery

MeSH Terms

Back Pain
Disability Evaluation
Endoscopy
Epidural Space
Female
Follow-Up Studies
Humans
Intervertebral Disc Displacement
Leg
Low Back Pain*
Male
Pain Measurement
Rehabilitation
Retrospective Studies*
Visual Analog Scale

Figure

• 

  Fig. 1 Visual analogue scale (VAS) for male (black) and female (grey) patients at pre-epiduroscopy (0), 1 month, 6 months and one year. There was a significant difference over time between gender and VAS (P = 0.026). The interaction between time and gender was not significant for VAS (P = 0.138).

• 

  Fig. 2 Oswestry disability index (ODI) for male (black) and female (grey) patients at pre-epiduroscopy (0), 1 month, 6 months, and 1 year. There was a significant difference over time between gender and ODI (P = 0.012). The interaction between time and gender was significant for ODI (P = 0.041).

• 

  Fig. 3 Visual analogue scale (VAS) scores for operated (grey) and non-operated (black) patients at pre-epiduroscopy (0), 1 month, 6 months, and 1 year. There was a significant difference over time between the operated/non-operated and VAS (P < 0.001). Also the interaction between time and operated/non-operated was significant for VAS (P < 0.001)

• 

  Fig. 4 Oswestry disability index (ODI) scores for operated (grey) and non-operated (black) patients at pre-epiduroscopy (0), 1 month, 6 months, and 1 year. There was a significant difference over time between the operated/non-operated and ODI (P < 0.001). Also the interaction between time and operated/non-operated was significant for ODI (P = 0.002).

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