Journal List > J Korean Med Assoc > v.49(8) > 1080674

Lee: Interventional Treatment of Low Back Pain

Abstract

Low back pain remains one of the biggest resource-consuming problems in medicine. At least 40% of the US population at one time or another will utilize medical resources for the treatment of low back pain. Multiple percutaneous and minimally invasive interventional techniques to treat moderate to severe back pain have recently been introduced, and they can be incorporated as part of the treatment planning or the diagnostic work-up process based on the response to them. When conventional treatment fails to provide satisfactory pain reduction and improvement of the quality of life, interventional techniques can be considered. Before starting any interventional treatment, a working diagnosis needs to be developed based on the patients' history, physical examination findings, and a review of objective studies. A careful selection of patients may significantly improve the success rate of these procedures.

References

1. Leonardo K, Joshua G. Interventional pain management: when/what therapies are best for low back pain. Current Opinion in Anaesthesiology. 2005. 18:569–575.
crossref
2. Raj PP. Practical management of pain. 1992. 2nd ed. Year Book Medical Publishers;818–820.
3. Bonica JJ, Backup PH, Anderson CE. Peridural block, an analysis of 3637 cases. Anesthesiology. 1957. 18:723–784.
4. Swerdlow M, Sayle-Creer W. A study of extradural medication in the relief of the lumbosciatic syndrome. Anaesthesia. 1970. 25:341–345.
crossref
5. Benzon HT. Epidural steroid injection for low back pain and lumbosacral radiculopathy. Pain. 1986. 24:277–295.
crossref
6. Abraham SE, Stephen E. Treatment of lumbosacral radiculopathy with epidural steroids. Anesthesiology. 1999. 91:1937.
crossref
7. Manchikanti L, Boswell MV, Singh V, Pampati V, Damron KS, Beyer CD. Prevalence of facet joint pain in chronic spinal pain of cervical, thoracic, and lumbar regions. BMC Musculoskelet Disord. 2004. 5:15.
crossref
8. Nikolai B. International spinal injection society guidelines for the performance of spinal injection procedures: part 1: zygapophysial joint blocks. Clin J Pain. 1997. 13:285–302.
9. Deer TR, Timothy . Injections for the diagnosis and treatment of spinal pain. Anesthesiology. 2004. 32:53–59.
crossref
10. Daniel RK, Yuming Y, Louis G, Keith HB, Lawrence GL, Carl L, et al. The effect of nerve-root injections on the need for operative treatment of lumbar radicular pain: A prospective, randomized, controlled, double-blind study. J Bone Joint Surg Am. 2000. 82:1589–1593.
11. Schwarzer AC, Aprill CN, Derby R, Fortin J, Kine G, Bogduk N. The false-positive rate of uncontrolled diagnostic blocks of the lumbar zygapophysial joints. Pain. 1994. 58:195–200.
crossref
12. van Wijk RM, Geurts JW, Wynne HJ. Radiofrequency denervation of lumbar facet joints in the treatment of chronic low back pain: a randomized, double-blind, sham lesion-controlled trial. Pain Practice. 2006. 6:147.
13. Sluijiter ME, Cosman ER, Rittman WA, Van Kleef M. The effects of pulsed radiofrequency fields applied to the dorsal root ganglion. Pain Cilinic. 1998. 11:109–107.
14. Stolker RJ, Vervest AC, Groen GJ. The management of chronic spinal pain by blockades: a review. Pain. 1994. 58:1–20.
crossref
15. Devulder J, Bogaert L, Castille F, Moerman A, Rolly G. Relevance of epidurography and epidural adhesiolysis in chronic failed back surgery patients. Clinical Journal of Pain. 1995. 11:147–150.
crossref
16. Igarashi T, Hirabayashi Y, Seo N, Saitoh K, Fukuda H, Suzuki H. Lysis of adhesions and epidural injection of steroid/local anaesthetic during epiduroscopy potentially alleviate low back and leg pain in elderly patients with lumbar spinal stenosis. British Journal of Anaesthesia. 2004. 93:181–187.
crossref
17. Saal JA, Saal JS. Intradiscal electrothermal treatment for chronic discogenic low back pain: a prospective outcome study with minimum 1-year follow-up. Spine. 2000. 25:2622–2627.
crossref
18. Kleinstueck FS, Diederich CJ, Nau WH, Puttlitz CM, Smith JA, Bradford DS, et al. Acute biomechanical and histological ef fects of intradiscal electrothermal therapy on human lumbar discs. Spine. 2001. 26:2198–2107.
crossref
19. Chou LH, Lew HL, Coelho PC, Slipman CW. Intradiscal electrothermal annuloplasty. Am J Phys Med Rehabil. 2005. 84:538–549.
crossref
20. Nakano M, Hirano N, Ishihara H. Calcium phosphate cement leakage after percutaneous vertebroplasty for osteoporotic vertebral fractures: risk factor analysis for cement leakage. J Neurosurg Spine. 2005. 2:27–33.
crossref
21. Lieberman IH, Dudeney S, Reinhardt MK, Bell G. Initial outcome and efficacy of 'kyphoplasty' in the treatment of painful osteoporotic vertebral compression fracture. Spine. 2001. 26:1631–1638.
crossref
23. Oakley JC. Spinal cord stimulation in axial low back pain: solving the dilemma. Pain Medicine. 2006. 7:Suppl. 58–53.
crossref
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