Epiduroscopy for Patients With Lumbosacral Radicular Pain

Jan Willem Kallewaard*, Pascal Vanelderen, Jonathan Richardson, Jan Van Zundert, James Heavner, Gerbrand Jan Groen

*Corresponding author for this work

Research output: Contribution to journalReview articleAcademicpeer-review

23 Citations (Scopus)

Abstract

Lumbosacral radicular pain is a pain in the distribution area of one of the nerves of the lumbosacral plexus, with or without sensory and/or motor impairment. A major source of lumbosacral radicular pain is failed back surgery, which is defined as persistent or recurrent pain, mainly in the region of the lower back and legs even after technically, anatomically successful spine surgeries. If lumbosacral radicular neuropathic pain fails to respond to conservative or interventional treatments, epiduroscopy can be performed as part of a multidisciplinary approach. Epiduroscopy aids in identifying painful structures in the epidural space, establishing a diagnosis and administering therapy. The novelty consists in the use of an epiduroscope to deliver therapies such as adhesiolysis and targeted administration of epidural medications. Clinical trials report favorable treatment outcomes in 30% to 50% of patients. Complications are rare and related to the rate or volume of epidural fluid infusion or inadvertent dural puncture. In patients with lumbosacral radicular pain, especially after back surgery, epiduroscopy with adhesiolysis may be considered (evidence rating 2 B+).

Original languageEnglish
Pages (from-to)365-377
Number of pages13
JournalPain practice
Volume14
Issue number4
DOIs
Publication statusPublished - Apr-2014

Keywords

  • epiduroscopy
  • low back pain
  • evidence-based medicine
  • systematic review
  • adhesiolysis
  • BACK SURGERY SYNDROME
  • SPINAL NERVE ROOTS
  • AUTOLOGOUS NUCLEUS PULPOSUS
  • LUMBAR EPIDURAL SPACE
  • CHRONIC SCIATICA
  • NEUROPATHIC PAIN
  • DIRECT VISUALIZATION
  • RADIATION-EXPOSURE
  • COMPRESSION
  • ENDOSCOPY

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