Evidence based medicine in the use of botulinum toxin for back pain
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- Jabbari, B. J Neural Transm (2008) 115: 637. doi:10.1007/s00702-007-0864-8
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Two randomized, prospective studies, one double blind and one open label, longterm evaluated efficacy and safety of Botulinum toxin A (Allergan-Inc) in 31 and 75 patients with chronic low back pain. Both studies used a novel technique imploying 5 level (L1 to L5) injections (40–50 units/level) of BoNT-A into erector spinae muscles. Significant (p < 0.05) improvement of pain intensity, frequency and activities of daily living was noted in 60% and 53% of the patients, respectively. The second study also depicted safety with repeated injections over 14 months of follow up. Botulinum toxin-A should be considered for treatment of low back pain when other modes of treatment fail to improve pain.