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Transcatheter Arterial Embolization Using Imipenem/Cilastatin Sodium for Chronic Low Back Pain Resistant to Conservative Treatment: A Pilot Study with 2-Year Follow-Up

CardioVascular and Interventional Radiology volume 44, pages 1964–1970 (2021)Cite this article

Abstract

Purpose

To evaluate the safety and 2-year follow-up clinical outcomes of transcatheter arterial embolization (TAE) using imipenem/cilastatin sodium for chronic low back pain resistant to conservative treatment.

Materials and Methods

A retrospective review identified 14 patients who underwent TAE for chronic low back pain between October 2017 and August 2018. Patients with low back pain related to the facet or sacroiliac joint, lasting ≥ 6 months, refractory to ≥ 3 months of conservative treatment were eligible for TAE. Each patient received embolization of feeding arteries of painful regions. The changes in brief pain inventory (BPI) scores, adverse events, and the Oswestry Disability Index (ODI) were evaluated at baseline and 1, 3, and 24 months after TAE. Clinical success was defined as BPI maximum pain intensity decrease of ≥ 2 and ODI decrease of ≥ 10 points from baseline.

Results

Follow-up data were available in 13 and 11 patients, at 3 and 24 months after embolization, respectively. Intention-to-treat clinical success was obtained in 11/14 (79%) of patients at 3 months and 8/14 (57%) of patients at 24 months after TAE. Mean BPI maximum pain intensity and ODI scores decreased significantly from baseline to 1, 3, and 24 months after treatment (7.6 vs.. 4.3, 3.4, and 4.1; 40.8 vs 21.5, 20.0, and 23.8, respectively; all P < 0.01). No major adverse events were associated with the procedures.

Conclusion

TAE is one possible treatment option for patients with chronic low back pain refractory to conservative treatment.

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Abbreviations

TAE:

Transcatheter arterial embolization

BPI:

Brief pain inventory

ODI:

Oswestry disability index

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Funding

This study received no funding support.

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Authors and Affiliations

  1. Musculoskeletal Intervention Center, Okuno Clinic, 4th Fl Ginrei Bldg., 7-8-4, Roppongi, Minato-ku, Tokyo, 106-0032, Japan

    Keishi Fujiwara, Masahiko Shibuya, Eiji Sugihara, Koichi Miyazaki, Takayuki Sakugawa & Yuji Okuno

  2. Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8654, Japan

    Shohei Inui

Authors
  1. Keishi Fujiwara
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  2. Shohei Inui
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  3. Masahiko Shibuya
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  4. Eiji Sugihara
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  5. Koichi Miyazaki
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  6. Takayuki Sakugawa
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  7. Yuji Okuno
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Corresponding author

Correspondence to Yuji Okuno.

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The authors declare that they have no conflict of interest.

Ethical Approval

The Institutional Review Board of Okuno Clinic approved this study (Approval Number: OC IRB 2020-0401).

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Informed consent was obtained from all individual participants included in the study.

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Consent for publication was obtained from every individual whose data are included in the study.

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Fujiwara, K., Inui, S., Shibuya, M. et al. Transcatheter Arterial Embolization Using Imipenem/Cilastatin Sodium for Chronic Low Back Pain Resistant to Conservative Treatment: A Pilot Study with 2-Year Follow-Up. Cardiovasc Intervent Radiol 44, 1964–1970 (2021). https://doi.org/10.1007/s00270-021-02976-1

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  • DOI: https://doi.org/10.1007/s00270-021-02976-1

Keywords

  • Chronic low back pain
  • Transcatheter arterial embolization
  • Brief pain inventory score
  • Oswestry disability index