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THE SATISFACTION IN MANAGEMENT OF CHRONIC RADICULAR PAIN IN PATIENTS WITH PREVIOUS LUMBAR SURGERY: PROSPECTIVE STUDY OF 140 PATIENTS
ESRA Academy. Zackova M. Sep 8, 2016; 138326; 0159 Topic: MISCELLANEOUS
Monika Zackova
Monika Zackova

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Abstract
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Background and Aims:

The aim of  this study is to evaluate efficacy of epidural steroids and other complementary  therapies in patients with recurrent lumbar and sciatic pain after lumbar spine surgery.

Methods:

78 men and 52 woman, with long standing low back pain, with or without radiation to one or both lower limbs were randomised to receive Methylprednisolone and Bupivacaine (group E) by epidural injection, and in addition functionally oriented rehabilitation program (group ER). All these patients had already undergone lumbar surgery some years ago. Before treatment and at 3, 6 and 12 months post-treatment, pain intensity, disability status and quality of life were measured.

Results:

In both groups pain and disability were reduced and quality of life increased (P ≤ 0,001). Improvement trend was faster in ER group (P ≤  0,05) with an important reduction in analgesic requirements.

At 6 month follow-up, 58 patients (82,8%) in ER group and 50 patients (71,4%) in E group had more than 50% pain reduction. There were no complications and more than 80% of patients decided not to undergo surgery.

Conclusions:

Pain relief obtained can improve the patient’ tolerance for a functionally oriented rehabilitation program. Especially Self-sufficiency is found to influence the association between pain and functioning, and to be prognostic factor for the outcome of functional ability in chronic pain patients. Our results suggested that steroid injection can be cost effective means of managing chronic radicular pain even after previous surgery. This is a prototype of multimodal approach.

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