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Minimally Invasive Treatment for Refractory Low Back Pain, Targeted by Epidural Endoscopy with O2/O3 and Steroid Therapy

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Advances in Minimally Invasive Surgery and Therapy for Spine and Nerves

Part of the book series: Acta Neurochirurgica Supplementum ((NEUROCHIRURGICA,volume 108))

Abstract

Purpose: Epidural endoscopy is an efficient option among conservative modalities in the management of refractory low back pain. The purpose of this paper is to evaluate retrospectively the effectiveness of the treatment of this condition with targeted O2/O3 and steroid therapy.

Material and Methods: The procedures were performed in 32 consecutive patients who failed to show significant response of at least 6 weeks or longer to treatments that included anti-inflammatory and analgesic drugs, physiotherapy and posterior epidural steroids and/or facet joint injections. These procedures were performed during the year 2006 and all the patients have been followed up for at least 2 years.

Results: Patients evaluated by Visual Analogue Scale (VAS) pre and immediately post procedure advised an improvement of mean 80% of their previous pain status. Follow-up revisions with 1, 3, 6, 12 and 24 months showed persistent improvement percentage at mean 60%. The Oswestry Disability Index showed significant changing in status pre and post procedure related to the pain control condition. No serious complications were related to the procedure.

Conclusions: Targeted Epidural endoscopy associated with injection of O2/O3 and steroids is a safe and efficient minimally invasive procedure to be used in patients with refractory low back pain. The association with ozone (O2/O3) and steroids seems to result in a long lasting pain relief, giving to the physician and to the patient a wider window to work on the treatment of other frequently associated causes (emotional, socio-economic and environmental) of refractory back pain.

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Conflict of interest statement

We declare that we have no conflict of interest.

AcknowledgmentThe authors want to thank Bio. Debora Viecili Costa Masini for data collection and statistical analysis and Dr. Joao Flavio Gurjao Madureira for bibliography revision and structuring.

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Authors and Affiliations

  1. School of Medicine University of Planalto Central and South Lake Hospital, Brasilia, Distrito Federal, Brazil

    Marcos Masini

  2. Department of Neurosurgery, Santa Casa Hospital, Maceio, Alagoas, Brazil

    Aldo Calaça

Authors
  1. Marcos Masini
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  2. Aldo Calaça
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Editors and Affiliations

  1. Istituto per lo studio e la cura delle, mallettie del sistema nervoso perif., European Neurosurgical Institut, Via Ghirada 2, Treviso, 31100, Italy

    Alberto Alexandre

  2. University of Planalto Central and South, School of Medicine, SCN Qd 05 Bl. A Sala 912, Brazil, Brazil

    Marcos Masini

  3. Florence and Rome University, Via Jacopo Nardi 15, Florence, 50132, Italy

    Pier Paolo Maria Menchetti

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Masini, M., Calaça, A. (2011). Minimally Invasive Treatment for Refractory Low Back Pain, Targeted by Epidural Endoscopy with O2/O3 and Steroid Therapy. In: Alexandre, A., Masini, M., Menchetti, P. (eds) Advances in Minimally Invasive Surgery and Therapy for Spine and Nerves. Acta Neurochirurgica Supplementum, vol 108. Springer, Vienna. https://doi.org/10.1007/978-3-211-99370-5_6

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  • DOI: https://doi.org/10.1007/978-3-211-99370-5_6

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  • Publisher Name: Springer, Vienna

  • Print ISBN: 978-3-211-99369-9

  • Online ISBN: 978-3-211-99370-5

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