The role of percutaneous neurolysis in lumbar disc herniation: systematic review and meta-analysis
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Background: Recalcitrant disc herniation may result in chronic lumbar radiculopathy or sciatica. Fluoroscopically directed epidural injections and other conservative modalities may provide inadequate improvement in some patients. In these cases, percutaneous neurolysis with targeted delivery of medications is often the next step in pain management. Methods: An evidence-based system of methodologic assessment, namely, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was used. Multiple databases were searched from 1966 to January 2021. Principles of the best evidence synthesis were incorporated into qualitative evidence synthesis. The primary outcome measure was the proportion of patients with significant pain relief and functional improvement (≥ 50%). Duration of relief was categorized as short-term (< 6 months) and long-term (≥ 6 months). Results: This assessment identified one high-quality randomized controlled trial (RCT) and 5 moderate-quality non-randomized studies with an application of percutaneous neurolysis in disc herniation. Overall, the results were positive, with level II evidence. Conclusions: Based on the present systematic review, with one RCT and 5 nonrandomized studies, the evidence level is II for percutaneous neurolysis in managing lumbar disc herniation.
Abstract
Background: Recalcitrant disc herniation may result in chronic lumbar radiculopathy or sciatica. Fluoroscopically directed epidural injections and other conservative modalities may provide inadequate improvement in some patients. In these cases, percutaneous neurolysis with targeted delivery of medications is often the next step in pain management. Methods: An evidence-based system of methodologic assessment, namely, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was used. Multiple databases were searched from 1966 to January 2021. Principles of the best evidence synthesis were incorporated into qualitative evidence synthesis. The primary outcome measure was the proportion of patients with significant pain relief and functional improvement (≥ 50%). Duration of relief was categorized as short-term (< 6 months) and long-term (≥ 6 months). Results: This assessment identified one high-quality randomized controlled trial (RCT) and 5 moderate-quality non-randomized studies with an application of percutaneous neurolysis in disc herniation. Overall, the results were positive, with level II evidence. Conclusions: Based on the present systematic review, with one RCT and 5 nonrandomized studies, the evidence level is II for percutaneous neurolysis in managing lumbar disc herniation.
참고문헌 (52)
- Manchikanti L, "Epidural interventions in the management of chronic spinal pain : American Society of Interventional Pain Physicians(ASIPP)comprehensive evidencebased guidelines", Pain Physician, 24(S1), pp.S27~S208 (2021)
- Mixter WJ, "Rupture of the intervertebral disc with involvement of the spinal canal", N Engl J Med, 211, pp.210~215 (1934)
- Andersson G, "The adult spine: principles and practice", pp.93~141 (1997), Raven Press
- Heliövaara M, "Epidemiology of sciatica and herniated lumbar intervertebral disc", The Social Insurance Institution, ~ (1988)
- Friberg S, "Anatomical and clinical studies on lumbar disc degeneration", Acta Orthop Scand, 19, pp.222~242 (1949)
- Schultz A, "Loads on the lumbar spine. Validation of a biomechanical analysis by measurements of intradiscal pressures and myoelectric signals", J Bone Joint Surg Am, 64, pp.713~720 (1982)
- Zhong M, "Incidence of spontaneous resorption of lumbar disc herniation : a metaanalysis", Pain Physician, 20, pp.E45~E52 (2017)
- Chiu CC, "The probability of spontaneous regression of lumbar herniated disc : a systematic review", Clin Rehabil, 29, pp.184~195 (2015)
- Ahn SH, "Effect of the transligamentous extension of lumbar disc herniations on their regression and the clinical outcome of sciatica", Spine (Phila Pa 1976), 25, pp.475~480 (2000)
- Manchikanti L, "Epidural injections for lumbar radiculopathy and spinal stenosis : a comparative systematic review and meta-analysis", Pain Physician, 19, pp.E365~E410 (2016)
- Oster BA, "Systematic review of outcomes following 10-year mark of Spine Patient Outcomes Research Trial for intervertebral disc herniation", Spine (Phila Pa 1976), 45, pp.825~831 (2020)
- Helm S 2nd, "Percutaneous and endoscopic adhesiolysis in managing low back and lower extremity pain : a systematic review and meta-analysis", Pain Physician, 19, pp.E245~E282 (2016)
- Manchikanti L, "Effectiveness of percutaneous adhesiolysis in post lumbar surgery syndrome : a systematic analysis of findings of systematic reviews", Pain Physician, 22, pp.307~322 (2019)
- Manchikanti L, "Effectiveness of percutaneous adhesiolysis in managing chronic central lumbar spinal stenosis : a systematic review and meta-analysis", Pain Physician, 22, pp.E523~E550 (2019)
- Manchikanti L, "Is percutaneous adhesiolysis effective in managing chronic low back and lower extremity pain in post-surgery syndrome : a systematic review and metaanalysis", Curr Pain Headache Rep, 24, pp.30~ (2020)
- Cho JH, "Treatment outcomes for patients with failed back surgery", Pain Physician, 20, pp.E29~E43 (2017)
- Manchikanti L, "Declining utilization patterns of percutaneous adhesiolysis procedures in the fee-for-service(FFS)medicare population", Pain Physician, 24, pp.17~29 (2021)
- Heavner JE, "Percutaneous epidural neuroplasty:prospective evaluation of 0.9% NaCl versus 10% NaCl with or without hyaluronidase", Reg Anesth Pain Med, 24, pp.202~207 (1999)
- Racz GB, "Pain management for clinicians: a guide to assessment and treatment", pp.523~653 (2020), Springer
- McCarron RF, "Techniques of neurolysis", pp.87~94 (1989), Kluwer Academic Publishers
- Adams MA, "What is intervertebral disc degeneration, and what causes it?", Spine (Phila Pa 1976), 31, pp.2151~2161 (2006)
- Kuslich SD, "The tissue origin of low back pain and sciatica : a report of pain response to tissue stimulation during operations on the lumbar spine using local anesthesia", Orthop Clin North Am, 22, pp.181~187 (1991)
- Lirong Zhu, "Toll-like receptor 4", nuclear factor-kappa B pathway is involved in radicular pain by encouraging spinal microglia activation and inflammatory response in a rat model of lumbar disc herniation, 2021, pp.34(1), 47~57[DOI]
- Derya Burcu Hazer, "The outcome of epiduroscopy treatment in patients with chronic low back pain and radicular pain, operated or non-operated for lumbar disc herniation: a retrospective study in 88 patients", The Korean Journal of Pain, 31(2), pp.109~115 (2018), 대한통증학회
- Gerdesmeyer L, "Percutaneous epidural lysis of adhesions in chronic lumbar radicular pain : a randomized, double-blind, placebo-controlled trial", Pain Physician, 16, pp.185~196 (2013)
- "Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)" (2021)[URL]
- Furlan AD, "Editorial Board of the Cochrane Back, Neck Group. 2015 updated method guideline for systematic reviews in the Cochrane Back and Neck Group", Spine (Phila Pa 1976), 40, pp.1660~1673 (2015)
- Manchikanti L, "Assessment of methodologic quality of randomized trials of interventional techniques : development of an interventional pain management specific instrument", Pain Physician, 17, pp.E263~E290 (2014)
- Manchikanti L, "Development of an interventional pain management specific instrument for methodologic quality assessment of nonrandomized studies of interventional techniques", Pain Physician, 17, pp.E2291~E2317 (2014)
- Manchikanti L, "A modified approach to grading of evidence", Pain Physician, 17, pp.E319~E325 (2014)
- 조평구, "Clinical Effectiveness of Percutaneous Epidural Neuroplasty According to the Type of Single-Level Lumbar Disc Herniation : A 12-Month Follow-Up Study", 대한신경외과학회지, 62(6), pp.681~690 (2019), 대한신경외과학회[DOI]
- Moon SH, "Comparative effectiveness of percutaneous epidural adhesiolysis for different sacrum types in patients with chronic pain due to lumbar disc herniation: a propensity score matching analysis", Medicine (Baltimore), 95, pp.e4647~ (2016)
- Moon SH, "Factors for predicting favorable outcome of percutaneous epidural adhesiolysis for lumbar disc herniation", Pain Res Manag, 2017, pp.1494538~ (2017)
- Taheri A, "Clinical evaluation of percutaneous caudal epidural adhesiolysis with the Racz technique for low back pain due to contained disc herniation", Anesth Pain Med, 6, pp.e26749~ (2016)
- Cho S, "Percutaneous epidural adhesiolysis with epidural steroid injection : a non-inferiority test of non-particulate steroids versus particulate steroids", Pain Med, 17, pp.1612~1619 (2016)
- Kalagac Fabris L, "Epidural adhesiolysis in the management of chronic low back pain in failed back surgery syndrome and in lumbar radicular pain : first year of experience at Pula General Hospital, Pula, Croatia – a randomized trial", Acta Med Croatica, 73, pp.57~65 (2019)
- Park SH, "Clinical significance of epidurography contrast patterns after adhesiolysis during lumbar percutaneous epidural neuroplasty", Pain Res Manag, 2018, pp.6268045~ (2018)
- Choi EJ, "A retrospective study to evaluate the effect of concentration of hypertonic saline on efficacy and safety of epidural adhesiolysis", Anesth Analg, 124, pp.2021~2029 (2017)
- Lee JH, "Clinical effectiveness of percutaneous adhesiolysis using Navicath for the management of chronic pain due to lumbosacral disc herniation", Pain Physician, 15, pp.213~221 (2012)
- 지규열, "Efficacy of Percutaneous Epidural Neuroplasty Does Not Correlate with Dural Sac Cross-Sectional Area in Single Level Disc Disease", Yonsei Medical Journal, 56(3), pp.691~697 (2015), 연세대학교의과대학[DOI]
- Veihelmann A, "Epidural neuroplasty versus physiotherapy to relieve pain in patients with sciatica : a prospective randomized blinded clinical trial", J Orthop Sci, 11, pp.365~369 (2006)
- "C R Seances Soc Biol Fil", 1901, 396~398
- Ter Meulen BC, "The epidural treatment of sciatica : its origin and evolution", Eur Neurol, 75, pp.58~64 (2016)
- Robecchi A, "Hydrocortisone (compound F); first clinical experiments in the field of rheumatology", Minerva Med, 43, pp.1259~1263 (1952)
- Lievre JA, "Hydrocortisone in local injection", Rev Rhum Mal Osteoartic, 20, pp.310~311 (1953)
- Manchikanti L, "Update on reversal and decline of growth of utilization of interventional techniques in managing chronic pain in the Medicare population from 2000 to 2018", Pain Physician, 22, pp.521~536 (2019)
- Manchikanti L, "Utilization patterns of facet joint interventions in managing spinal pain : a retrospective cohort study in the US fee-for-service Medicare population", Curr Pain Headache Rep, 23, pp.73~ (2019)
- Manchikanti L, "Declining utilization and inflation-adjusted expenditures for epidural procedures in chronic spinal pain in the Medicare population", Pain Physician, 24, pp.1~15 (2021)
- Manchikanti L, "Cervical interlaminar epidural injections in the treatment of cervical disc herniation, post surgery syndrome, or discogenic pain : cost utility analysis from randomized trials", Pain Physician, 22, pp.421~431 (2019)
- Manchikanti L, "Cost utility analysis of lumbar interlaminar epidural injections in the treatment of lumbar disc herniation, central spinal stenosis, and axial or discogenic low back pain", Pain Physician, 20, pp.219~228 (2017)
- Chou R, "Epidural corticosteroid injections for radiculopathy and spinal stenosis : a systematic review and meta-analysis", Ann Intern Med, 163, pp.373~381 (2015)
- Manchikanti L, "Comprehensive evidence-based guidelines for facet joint interventions in the management of chronic spinal pain : American Society of Interventional Pain Physicians(ASIPP)guidelines facet joint interventions 2020 guidelines", Pain Physician, 23(3S), pp.S1~S127 (2020)
