Rafik Sedra, an advanced pain trainee from Oxford school of anaesthesia, and Dr Pradeep Desai, chronic pain consultant at Wexham Park Hospital, discuss their research – a retrospective study and case series about epiduroplasty
Abstract
Background: Chronic lower back pain (LBP) and radicular pain following failed back surgery and spinal canal stenosis is not uncommon. Percutaneous epidural adhesiolysis with hypertonic saline as a three-day or one-day procedure has been established (8). We present retrospective cases using normal saline as one-day protocol.
Objectives: To retrospectively assess the efficacy of one-day epiduroplasty using normal saline instead of hypertonic saline to improve pain, function and quality of life (QOL) in patients with failed back surgery syndrome (FBSS) and spinal stenosis.
Method: Retrospective data collection.
Results: Our study shows the range of duration of pain control is between one month and 48 months, with improvement of quality of life and function.
Conclusion: One-day protocol epiduroplasty using normal saline can be an effective and safe procedure for patients of FBSS and spinal canal stenosis with lower back pain (LBP) and radicular leg pain.
Limitation: Non-randomised, non-blinded, retrospective small study.
Background
Chronic back and leg pain is triggered from various structures in the spine. The pain generators can be intervertebral discs, nerve roots, dura, facet joints, ligaments, fascia and muscles as tissues capable of transmitting pain in the low back and lower extremity (7,8). The aetiology and pathophysiology of LBP and radicular pain has