Spinal endoscopy in chronic low back pain with radiculopathy - A prospective case series

All 38 patients listed for day-case spinal endoscopy over a 12-month period (April 1998 - April 1999), who had chronic severe low back pain with a rad iculopathic element, were studied prospectively. The mean [range] pain dura tion before treatment was 10.9 [2-26] years and 50% had failed back surgery syndrome. In all patients in whom treatment was completed (n = 34), the pa in-generating nerve roots were located through symptom interaction with the patient. All had epidural scar tissue. 14 (41%) having dense adhesions. Mo bilisation of adhesions around the nerve root (neuroplasty) was performed s o that a pocket was formed for the subsequent placement of bupivacaine, Dep omedrone and clonidine. No intra-operative complications occurred and side- effects were minimal. Follow-up over a 12-month period showed statistically significant reductions in pain scores and disability. Spinal endoscopy may be the diagnostic method of choice: for epidural fibrosis. It has substant ial therapeutic and research potential. Prospective randomised studies are required.