Systematic review of effectiveness and complications of adhesiolysis in the management of chronic spinal pain: an update.

摘要: BACKGROUND Percutaneous epidural adhesiolysis and spinal endoscopic are interventional pain management techniques used to treat patients with refractory low back due scarring. Standard steroid injections often ineffective, especially in prior surgery. Adhesions the space can prevent flow of medicine target area; lysis these adhesions improve delivery medication affected areas, potentially improving therapeutic efficacy injected medications. STUDY DESIGN A systematic review utilizing methodologic quality criteria Cochrane Musculoskeletal Review Group for randomized trials established by Agency Healthcare Research Quality (AHRQ) evaluation non-randomized trials. OBJECTIVE To evaluate update effectiveness percutaneous managing chronic lower extremity radiculopathy, or without lumbar surgery, since 2005 review. METHODS Basic search identified relevant literature, MEDLINE, EMBASE, BioMed databases (November 2004 September 2006). Manual searches bibliographies known primary articles, abstracts from scientific meetings within last 2 years were reviewed. Randomized studies included based on established. analyzed separately. OUTCOME MEASURES The outcome measure was significant relief (50% greater). Other measures functional improvement, improvement psychological status, return work. Short-term defined as less than 3 months, long-term months longer. RESULTS Studies regarding treatment sought evidence previous combined new November 2004. There is strong short term moderate long endoscopy. CONCLUSION endoscopy may be effective interventions caused adhesions.