Epiduroscopy in treatment of degenerative chronic low back pain: A prospective analysis and follow-up at 60 months

Abstract

The aim of this prospective study was to evaluate the efficacy of endoscopic epidurolysis in the treatment of degenerative chronic low back pain. Three-hundred and fifty patients with Visual analog scale (VAS) and Oswestry Low Back Pain Disability Index (ODI) from 0–60% (0–20%, group A; 20–40%, group B; 40–60%, group C) were enrolled and treated prospectively with endoscopic epidurolysis by means of a Myelotec endoscope and by the intermittent instillation of saline solution added with hyaluronidase. Targeted application of ozone and ciprofloxacin close to the abnormal areas was also performed. Short- and long-term efficacy was prospectively evaluated. A VAS score < 5 and ODI < 40% were considered as a positive outcome. The treatment significantly reduces the VAS in all three groups of patients, starting from the first week and throughout the entire follow-up period (p < 0.001), also the Disability Index (ODI) showed a statistically significant decrease of the score (p < 0.001), that was particularly evident at 3 months and maintained up to long-term follow-up intervals. In conclusion, epiduroscopy by mechanical adhesiolysis and administration on targeted areas of ciprofloxacina and ozone seems to be, in this prospective study, an effective technique to provide sensible and persisting pain relief and act of improving ODI in chronic low back pain.