A new approachs to the treatment of рain syndrome in lumbar-sacral spine

Authors

  • G.S. Moskovko National Pirogov Memorial Medical University, Vinnytsia, Ukraine
  • O.I. Datsyuk National Pirogov Memorial Medical University, Vinnytsia, Ukraine
  • Ya.V. Nikitchuk National Pirogov Memorial Medical University, Vinnytsia, Ukraine
  • A.V. Kostiuchenko National Pirogov Memorial Medical University, Vinnytsia, Ukraine
  • N.V. Titarenko National Pirogov Memorial Medical University, Vinnytsia, Ukraine

DOI:

https://doi.org/10.22141/2224-0586.7.102.2019.180355

Keywords:

рain syndrome, lumbar spine, degenerative-dystrophic diseases, herniated discs, epidural injections

Abstract

Background. The lumbar spine pain remains one of the most pressing medical and social problems. The purpose of the study was to assess the efficacy of the combined use of transforaminal and caudal epidural blockades for treatment of the lumbar spine pain syndrome due to the degenerative-dystrophic changes of the spine. Materials and methods. The study included 228 (85 males, 143 females) patients aged 52.07 ± 13.95 years with lumbar spine pain due to the degenerative-dystrophic changes. Among them, 114 patients received transforaminal epidural blockade and 114 — caudal epidural blockade. Results. The positive therapeutic effect was registered in 150 (65.8 %) patients. The rest 78 patients presented with a recurrent pain syndrome of up to 5 or more points on VAS underwent repeated procedures with a total number of up to four within 4 to 14 days after the first blockade. They were divided into three groups. Group 1 included the patients who received transforaminal epidural blockade (n = 26); group II consisted of the patients who received caudal epidural blockades (n = 26) and group 3 involved the patients undergone the combined use of transforaminal and caudal epidural blockades (n = 26). At starting therapeutic intervention, after hour 1, week 3, and month 3 after the injections, lumbar spine pain intensity, tension sign (straight leg raising test), lumbar mobility and the quality of life (the Oswestry Disability Index) were assessed for all groups. Conclusions. The combined use of transforaminal and caudal epidural blockades is a more effective method for treatment of the lumbar spine pain syndrome and is associated with a positive dynamic in the quality of life of a patient. The transforaminal or caudal epidural blockades only were effective during the short term.

Downloads

Download data is not yet available.

References

Goubert D., Oosterwijck J.V., Meeus M., Danneels L. Structural Changes of Lumbar Muscles in Non-specific Low Back Pain: A Systematic Review. Pain Physician. 2016. 19(7). E985-E1000.

Loh E., Reid J.N., Alibrahim F., Welk B. Retrospective cohort study of healthcare utilization and opioid use following radiofrequency ablation for chronic axial spine pain in Ontario, Canada. Reg. Anesth. Pain Med. 2019 Jan 23. pii: rapm-2018-100058. doi: 10.1136/rapm-2018-100058.

Singh J.R., Cardozo E., Christolias G.C. The Clinical Efficacy for Two-Level Transforaminal Epidural Steroid Injections. PM R. 2017. 9(4). 377-82. doi: 10.1016/j.pmrj.2016.08.030.

Kovacs F.M., Arana E. Degenerative disease of the lumbar spine. Radiologia. 2016. 58(Suppl. 1). 26-34. doi: 10.1016/j.rx.2015.12.004.

Celenlıoglu A.E., Sencan S., Gunduz O.H. Does facet tropism negatively affect the response to transforaminal epidural steroid injections? A prospective clinical study. Skeletal Radiol. 2019. 48(7). 1051-8. doi: 10.1007/s00256-018-3129-8.

Manchikanti L., Kaye A.D., Boswell M.V., Bakshi S., Gharibo C.G., Grami V., Grider J.S. et al. A Systematic Review and Best Evidence Synthesis of the Effectiveness of Therapeutic Facet Joint Interventions in Managing Chronic Spinal Pain. Pain Physician. 2015. 18(4). E535-82.

Govind J. Lumbar radicular pain. Aust. Fam. Physician 2004. 33(6). 409-12.

Valat J.P., Genevay S., Marty M., Rozenberg S., Koes B. Sciatica. Best Pract. Res. Clin. Rheumatol. 2010. 24. 241-52. doi: 10.1016/j.berh.2009.11.005.

Choi Y.K. Lumbar foraminal neuropathy: an update on non-surgical management. Korean J. Pain. 2019. 32(3). 147-59.

Shiban E., von Lehe M., Simon M., Clusmann H., Heinrich P., Ringel F., Wilhelm K., Urbach H., Meyer B., Stoffel M. Evaluation of degenerative disease of the lumbar spine: MR/MR myelography versus conventional myelography/post-myelography CT. Acta Neurochir. (Wien). 2016. 158(8). 1571-8. doi: 10.1007/s00701-016-2849-6.

Kennedy D.J., Zheng P.Z., Smuck M., McCormick Z.L., Huynh L., Schneider B.J. A minimum of 5-year follow-up after lumbar transforaminal epidural steroid injections in patients with lumbar radicular pain due to intervertebral disc herniation. Spine J. 2018. 18(1). 29-35. doi: 10.1016/j.spinee.2017.08.264.

Kozlov N., Benzon H.T., Malik K. Epidural steroid injections: update on efficacy, safety, and newer medications for injection. Minerva Anestesiol. 2015. 81(8). 901-9.

Rivera C.E. Lumbar epidural steroid injections. Phys. Med. Rehabil. Clin. N. Am. 2018. 29(1). 73-92. doi: 10.1016/j.pmr.2017.08.007.

Manchikanti L., Cash K.A., Pampati V., McManus C.D., Damron KS. Evaluation of fluoroscopically guided caudal epidural injections. Pain Physician. 2004. 7(1). 81-92.

Published

2021-10-01

How to Cite

Moskovko, G., Datsyuk, O., Nikitchuk, Y., Kostiuchenko, A., & Titarenko, N. (2021). A new approachs to the treatment of рain syndrome in lumbar-sacral spine. EMERGENCY MEDICINE, (7.102), 26–32. https://doi.org/10.22141/2224-0586.7.102.2019.180355

Issue

Section

Original Researches

Most read articles by the same author(s)