Hazer Derya Burcu, Acarbaş Arsal, Rosberg Hans Eric
Department of Neurosurgery, Faculty of Medicine, Mugla Sitki Kocman University, Mugla, Turkey.
Department of Translational Medicine-Hand Surgery, Skane University Hospital, Lund University, Malmö, Sweden.
Korean J Pain. 2018 Apr;31(2):109-115. doi: 10.3344/kjp.2018.31.2.109. Epub 2018 Apr 2.
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.
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.
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.
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.
腰椎间盘突出症患者接受物理治疗/药物治疗,部分患者接受手术治疗。然而,即使手术在技术上取得成功,一些患者仍会出现持续性疼痛的失败综合征。我们的目的是评估硬膜外腔镜检查对患有慢性腰痛和/或神经根性疼痛(无论是否接受过手术)患者的疗效以及结果中的性别差异。
共纳入88例患者,平均年龄52岁(27 - 82岁),其中女性54例,男性34例。他们中66例曾接受过手术,22例未接受过手术。尽管接受了药物治疗和物理康复治疗,他们均患有持续性慢性背痛和神经根性疼痛。在硬膜外腔镜检查术前、术后1个月、6个月和1年评估疼痛视觉模拟量表(VAS)和Oswestry功能障碍指数(ODI)。
所有患者以及各亚组(性别和手术/未手术)在术后1个月时疼痛(VAS)和功能障碍(ODI)均有显著改善。1年后也有显著改善。在不同随访时间,男性和女性之间未发现差异。除未手术组外,随着时间推移,VAS和ODI略有恶化。
硬膜外腔镜检查有助于早期改善因腰椎间盘突出症引起的腰腿痛。1年后仍有改善,未手术组似乎从该手术中获益最大。