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Keywords:
Interventional non-vascular, Management, Musculoskeletal spine, CT, Technical aspects
Authors:
S. A. Z. Khodair, E. Mashaly, H. Sameer; Qwuesna/EG
DOI:
10.1594/ecr2015/B-0345
Conclusion
Low back pain is one of the most frequently reported symptoms in the industrialized world (9).
About two-thirds of the population suffers from back pain at some point of time during their life span (10) and this symptom incapacitates 20% of them for long periods (>4 weeks) (11).
In this work ,
patient with radicular pain either with or without intervertebral disc bulge on MRI imaging had received nerve root block at the level of intervertebral disc bulge or according to the site of pain guided by body map dermatome.
In a study by Zennaro et al (12),
selective nerve root injection provided pain relief in 70% of all patients and in 95% of patients with foraminal stenosis secondary to degenerative stenosis rather than disk herniation.
Patients had tenderness over sacroiliac joint with erosion and sclerosis of joint underwent sacroiliac joint injection.
Luukkainen et al.(13) used criteria for sacroiliac joint injection comprised of the region of the pain,
tenderness in the SIJ,
and positive results on at least one of three provocation tests: Gaenslen’s test,
Patrick’s test,
or Newton’s test.
In this study,
levels for injection were selected on the basis of local pain or tenderness and imaging evidence of disease.
It is often difficult to localize the pain to one level,
so that generally two and occasionally three levels were injected.
If the pain is bilateral,
injections were performed bilaterally.
In present study ,
we used the Revised Oswestry disability as a scale for assessment of pain severity and functional status of our patients.
It was done by a standard questionnaire before ,
after 1 week and after 1 month of spinal injections.
Schulte et al (14) conducted a Prospective study included 39 patients with chronic low back pain diagnosed as lumbar facet syndrome.
Injection of steroid,
lidocaine,
and 5% phenol under fluoroscopic control.
Outcomes were determined on a follow-up based specialty questionnaire including: visual analog scale,
McNab criteria,
and pain disability index.
Pain relief of up to 6 months was reported after the treatment.
The outcome was assessed as excellent or good by 62% of the patients after 1 month,
by 41 after 3 months,
and 36 after 6 months.
In conclusion; the variety of studies techniques with satisfactory outcome and positive impact on social and psychological status of patients could make guided spinal injection recommended option for management of chronic low back pain.