Affiliations: [a] Department of Orthopaedics, Physical Medicine and Rehabilitation, Ludwig-Maximilians-University of Munich, Munich, Germany | [b] Department for Spine Therapy, Sportclinic Stuttgart, Stuttgart, Germany | [c] SRH Health Center, Bad Herrenalb, Germany | [d] Orthopaedie Centrum 30, Fellbach, Germany | [e] Neurochirurgische Klinik, Klinikum Karlsruhe, Karlsruhe, Germany | [f] Bathildis Krankenhaus, Bad Pyrmont, Germany | [g] Ruhr-University Bochum, Bochum, Germany
Abstract: BACKGROUND: It is estimated that a significant number of spinal surgeries are performed, but many patients do not often benefit. OBJECTIVE: Our aim was to determine how effective minimally invasive pain procedures (MIP) are in chronic low back pain (CLBP) patients with proven degenerative causes (specific low back pain). METHODS: 386 eligible patients with CLBP/sciatica resistant to conservative therapy and scheduled for open surgery were screened, and 167 could be enrolled in this study. Indications for MIP in the remaining 150 individuals were made by one experienced spinal surgeon. Before and 6 months after the intervention, the numeric rating scale (NRS) and Oswestry Disability Index (ODI) were recorded. MIP was performed, such as radiofrequency of the facet and SI-joint, intradiscal electrothermal therapy in case of discogenic pain, as well as epidural neuroplasty in patients with disc herniation/epidural fibrosis. RESULTS: There was a statistically significant decrease in NRS (p< 0.05), as well as a significant increase in ODI (p< 0.001) 6 months after the procedures. This was also true for the results of all different pain generators and subsequent performed procedures alone. CONCLUSIONS: The indication of MIP should be routinely reviewed in patients with CLBP to avoid potentially open surgery and a burden on healthcare costs.
