Role of epidural adhesiolysis in treatment of low back pain caused by herniated intervertebral discs

Authors

  • I. V. Fishchenko State Institution “Institute of Traumatology and Orthopedics of National Academy of Medical Sciences of Ukraine”, Kyiv, Ukraine

Keywords:

disc herniation, epidural adhesiolysis, conservative treatment

Abstract

Epidural adhesiolysis (EA) – a minimally invasive method of treatment of low back pain in lumbosacral spine in various degenerative diseases and postoperative fibrosis.

Purpose.

To analyze the results of treatment of low back pain syndrome on the background of hernias of intervertebral discs of the lumbosacral spine and to identify the prognostic factors that affect treatment outcomes.

Material.

А prospective study analyzed the data of 105 patients with diagnosis of herniated disc of the lumbosacral spine, who underwent inpatient treatment using epidural adhesiolysis in department of rehabilitation of SI “Institute of Traumatology and Orthopedics of NAMS of Ukraine” in 2013–2015.

Results.

Our study has shown high effectiveness of epidural adhesiolysis in treatment of low back pain caused by hernias of intervertebral discs of lumbosacral spine according to the survey of VAS, Roland Morris and Oswestry Disability Index. The presence of degenerative lumbar scoliosis and osteoarthritis of the hip joints has a negative effect on treatment outcome and relates to adverse prognostic factors of treatment of pain by means of epidural adhesiolysis.

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References

Фищенко Я. В. Эпидуральный адгезиолиз: опыт применения у больных с поясничным спинальным стенозом /Я. В. Фищенко, О. О. Перепечай //Вісник ортопедії, травматології та протезування. – № 4. – 2014. – С. 36–41.

Andersson G. Epidemiology of spinal disorders / G. Andersson, J. W. Frymoyer, T. B. Ducker, N. M. Hadler еt al. // The Adult Spine: Principles and Practice. Raven Press. – New York, 1997. – Р. 93–141.

Borenstein D. G. The value of magnetic resonance imaging of the lumbar spine to predict low-back pain in asymptomatic subjects: A sevenyear follow-up study / D. G. Borenstein, J. Jr. O’Mara, S. D. Boden et al. // Bone Joint Surg. Am. – 2001. – Vol. 83. – Р. 1306–1311.

Carragee Е. Clinical outcomes after discectomy for sciatica: The effects of fragment type and anular competence / E. Carragee, M.Y. Han, P.W. Suen et al. // Bone J Surg. Am. – 2003. – Vol. 85. – Р. 102–108.

Datta S. Diagnostic utility of selective nerve root blocks in the diagnosis of lumbosacral radicular pain: Systematic review and update of current evidence S. Datta, L. Manchikanti, FJ. Falco et al. // Pain Physician. – 2013. – Vol. 16. – Р. 145–172.

Falco FJ. An update of the systematic assessment of the diagnostic accuracy of lumbar facet joint nerve blocks / FJ. Falco, L. Manchikanti, S. Datta et al// Pain Physician. – 2012. – Vol. 15. – Р. 869–907.

Hahne A. J. Conservative management of lumbar disc herniation with associated radiculopathy: A systematic review / A. J. Hahne, J. J. Ford, J. M. McMeeken // Spine (Phila Pa 1976). – 2010. – Vol. 35. – Р. 488–504.

Heliovaara M. Epidemiology of Sciatica and Herniated Lumbar Intervertebral Disc / M. Heliovaara // The Social Insurance Institution, Helsinki, 1988.

Hirabayashietal K. Operative results and postoperative progression of ossification among patients with ossification of cervical posterior longitudinal ligament / K. Hirabayashi, J. Miyakawa, K. Satomi [et al.] // Spine. – 1981. – Vol. 6. – P. 354–364.

Jacobs W. C. Surgery versus conservative management of sciatica due to a lumbar herniated disc: A systematic review / W. C. Jacobs, M. van Tulder, M. Arts et al // Eur Spine J. – 2011. – Vol. 20. – Р. 513–522.

Konstantinou K. Sciatica: Review of epidemiological studies and prevalence estimates./ K. Konstantinou, K. M. Dunn // Spine (Phila Pa. 1976). – 2008. – Vol. 33. – P. 2464–2472.

Lee J. H. Clinical effectiveness of percutaneous adhesiolysis using Navicath for the anagement of chronic pain due to lumbosacral disc herniation/ J. H. Lee// PainPhysician. – 2012. – May – Jun;15(3). – Р. 213–211.

Manchikanti L. An update of the systematic appraisal of the accuracy of utility of lumbar discography in chronic low back pain / L. Manchikanti, R. M. Benyamin, V. Singh et al. // Pain Physician. – 2013. – Vol. 16. – Р. 103–143.

Mixter W. J. Rupture of the intervertebral disc with involvement of the spinal canal / W. J. Mixter, J. S. Barr// N.Eng. J Med. – 1934. –Vol. 211. – P. 210–215.

Miyagi M. Disk injury in rats produces persistent increases in pain-related neuropeptides in dorsal root ganglia and spinal cord glia but only transient increases in inflammatory mediators: Pathomechanism of chronic diskogenic low back pain / M. Miyagi, T. Ishikawa, S. Orita et al. // Spine (PhilaPa 1976). – 2011. – Vol. 36. – Р. 2260–2266.

O’Neill C. Accuracy of MRI for diagnosis of discogenic pain / C. O’Neill, M. Kurgansky, J. Kaiser, W. Lau // Pain Physician. – 2008. – Vol. 11. – P. 311–326.

Parr A. T. Lumbar interlaminar epidural injections in managing chronic low back and lower extremity pain: A systematic review / A. T. Parr, S. Diwan, S. Abdi // Pain Physician. – 2009. – Vol. 12. – Р. 163–188.

Postacchini F. Etiopathogenesis/ F. Postacchini, G. Cinotti (ed) // Lumbar Disc Herniation. Spring-Verlag, New York, 1999. – Р. 151– 164.

Tosteson A. N. Comparative effectiveness evidence from the spine patient outcomes research trial: Surgical versus nonoperative care for spinal stenosis, degenerative spondylolisthesis, and intervertebral disc herniation/A. N. Tosteson, T. D. Tosteson, J. D. Lurie et al. // Spine (Phila Pa 1976). – 2011. – Vol. 36. – Р. 2061–2068.

Vad V. B. Transforaminal epidural steroid injections in lumbosacral radiculopathy: A prospective randomized study / V. B. Vad, A. L. Bhat, G. E. Lutz, F. Cammisa // Spine (Phila Pa 1976). – 2002. – Vol. 27. – Р. 11–16.

Wilco C. Surgical techniques for sciatica due to herniated disc, a systematic review / C. Wilco, W. Jacobs, P. Mark, Maurits W. van Tulder et al. // PeulEur Spine J. – 2012, November. – Vol. 21(11). – P. 2232–2251.

Published

2017-03-01

How to Cite

1.
Fishchenko IV. Role of epidural adhesiolysis in treatment of low back pain caused by herniated intervertebral discs. PMJUA [Internet]. 2017 Mar. 1 [cited 2021 Dec. 9];2(1):62-8. Available from: https://painmedicine.org.ua/index.php/pnmdcn/article/view/49

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Section

Original method

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