Efficacy of Therapeutic Fluoroscopy-Guided Lumbar Spine Interventional Procedures
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- Category: Vol. 81, March 2013
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Efficacy of Therapeutic Fluoroscopy-Guided Lumbar Spine Interventional Procedures, AYMAN E.A. GALHOM and MOHAMED A. AL-SHATOURI
Abstract
Background: Interventional techniques in the management of chronic spinal pain are statements developed to improve quality of care, patient access, and improved treatment out-comes.
Objective: To evaluate the therapeutic benefit of fluoros-copy guided lumbar spine interventional procedures using anesthetics and steroid in the treatment of back and radicular pain related to disc and degenerative lumbar spine diseases.
Patients and Methods: This prospective descriptive study was performed on 60 patients with back or radicular pain. Patients received fluoroscopy guided lumbar spine injections after showing no improvement with conservative medical treatment. The patients were evaluated radiologically and clinically using questionnaires, prior to initial injection, at 6 weeks, 6 months and 12 months after the injections. Outcome questionnaires measures include: Visual analog scale (VAS) and Oswestry low back pain disability index (ODI).
Results: Patients were predominately female (63.3%) with a mean age of 42±12.8 years. Along the year, 102 injections sessions were done. The majority of injections were transforaminal epidural (46.7%) followed by medial branch block (23.3%). Eleven patients (18.3%) failed to improve after intervention and required surgeries. pre and post injection analysis of the remaining cases (81.7%) showed statistically significant VAS improvement after spine intervention at six months with mean 4.12±1.05 (p<0.024), and at 12 months with mean 3.51±.73 (p<0.032). ODI displayed marked im-provement in relation to pre interventional ODI degree with p<0.031 andp<0.042 at six and twelve months respectively.
Conclusion: Fluoroscopy guided lumbar spine injections significantly reduced both back and radicular pain and im-proved disability in patients with symptomatic discogenic and degenerative lumbar spinal diseases.