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KMID : 1150320060020010082
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Journal of Korean Society of Geriatric Neurosurgery
2006 Volume.2 No. 1 p.82 ~ p.88
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Role of Nerve Block and Radiofrequency Neurotomy in Management of Chronic Low Back Pain of Spinal Origin in Elderly Patients
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Jo Tae-Yeon
Park Jun-O
Kim Sang-Dae
Lee Jang-Bo
Lim Dong-Jun
Park Jung-Yul
Chung Heung-Seob
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Abstract
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Purpose: We report our study to establish, in elderly patient population, the benefit of minimally invasive procedure for the pain relief and restoration of functional capabilitles without surgical interventions.
Method: We analyzed 670 patients over 65 years old with refractory chronic low back pain with or without leg pain between jan 2002 and May 2004. Posterior primary ramus [PPR] block and/or dorsal root ganglion (DRG) block were performed in all patients and radiofirequency (RF) neurotomy was additionally performed in 183 patients. Pain relief was estimated at 1 week, 1 month, 3 months and 6 months using visual analog scale (VAS). Patients who fel pain relief more than 50% on VAS were regarded as suecessful responders.
Results: Of 670 patients who underwent neural blocks,percentages of successful responders were 81% at 1 week, 60% at 1 month, 57.4% at 3 months and 54.9% at 6 months. Of these patients, 183 patients who showed initial successful response but experienced symptom recurrence were selected for RF neuroiomy. Among these patients, percentages of positive responders were 71% at 1 week, 71.5% at 1 month, 68.8% at 3 months, and 57.3% at 6 months. there were no serious complications related that procedure.
Conclusions: These results indicate that the nerve blocks (PPR and/or DRG) and RF neruotomy provide substantial pain relief with prolonged duration of good efficacy and advanlages such as simplicity, safety of the procedrue, and repeatability. Therefore, such trealments can be recommended in elderly patinents with chronic low back pain that is not controlled with conservative managements and/or not suitable for surgery.
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KEYWORD
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Elderly, Low back pain, Neural block, Perecutaneous radiofrequency, Lesioning
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