Results of Lumbar Endoscopic Adhesiolysis Using a Radiofrequency Catheter in Patients with Postoperative Fibrosis and Persistent or Recurrent Symptoms After Discectomy

• Type: Article in International Scientific Journal
• Date: 2016

Authors

Paulo Pereira (Author) FMUP; Severo M (Author) FMUP; Monteiro, P (Author) Other; Silva, PA (Author) FMUP; Rebelo, V (Author) Other; Castro-Lopes J.M. (Author) FMUP; Rui Vaz (Author) FMUP

Journal

Title: Pain Practice

Vol. 16

Pages: 67-79

ISSN: 1530-7085

Publisher: Wiley-Blackwell

Indexing

ISI Web of Knowledge - 18 Citations

Scopus - 20 Citations

Other information

Authenticus ID: P-00K-3QV

DOI: 10.1111/papr.12266

Abstract (EN): Objective: To evaluate the results of lumbar epiduroscopic adhesiolysis using mechanical methods and a radiofrequency catheter followed by epidural steroid and local anesthetic administration in patients with postoperative fibrosis and persistent or recurrent symptoms. Study Design: Prospective study. Methods: Patients with persistent or recurrent low back and/or lower limb pain after lumbar spine surgery, in whom no relevant findings were present on MR images besides epidural scar tissue, were submitted to epiduroscopic adhes-iolysis. Patient-reported outcomes including pain and disability were assessed in predefined time intervals and compared to baseline. Results: Twenty-four patients were enrolled. It was possible to elicit the patient's usual pain by probing the epidural scar tissue in all patients. Statistically significant improvement in low back and lower limb pain was observed in all assessment periods up to 12 months. A pain relief over 50% was achieved in 71% of the patients at 1 month, 63% at 3 and 6 months, and 38% at 12 months. Disability scores significantly improved for around 6 months. Mean patient satisfaction rates were 80% at 1 month, 75% at 3 months, 70% at 6 months, and 67% 1 year after intervention. Only 1 transient postprocedural complication was detected. Conclusion: Endoscopic adhesiolysis is a potentially useful treatment for the relief of chronic intractable low back and lower limb pain in patients with previous lumbar spine surgery and epidural fibrosis. The use of larger volumes of saline during endoscopy and the employment of radiofrequency for the lysis of epidural adhesions are safe procedures, which may provide an additional benefit to the intervention.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 13