Guidelines for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 13: injection therapies, low-back pain, and lumbar fusion.
In summary, there is no meaningful evidence in the medical literature that the use of epidural injections is of any long-term value in the treatment of patients with chronic low-back pain. The literature does indicate that the use of lumbar epidural injections can provide short-term relief in selected patients with chronic low-back pain. There is evidence that suggests that facet joint injections can be used to predict outcome after RF ablation of a facet joint. The predictive ability of facet joint injections does not appear to apply to lumbar fusion surgery. No evidence exists to support the effectiveness of facet injections in the treatment of patients with chronic low-back pain. There is conflicting evidence suggesting that the use of local TPIs can be effective for the short-term relief of low-back pain. There are no data to suggest that TPIs with either steroids or anesthetics alone provide lasting benefit for patients suffering from chronic low-back pain.
Resnick
Daniel K
DK
Department of Neurosurgery, University of Wisconsin Medical School, Madison, Wisconsin 53792, USA. Resnick@neurosurg.wisc.edu
Choudhri
Tanvir F
TF
Dailey
Andrew T
AT
Groff
Michael W
MW
Khoo
Larry
L
Matz
Paul G
PG
Mummaneni
Praveen
P
Watters
William C
WC
Wang
Jeffrey
J
Walters
Beverly C
BC
Hadley
Mark N
MN
D000777:Anesthetics / Q000008:administration & dosage; D003131:Combined Modality Therapy; D006801:Humans; D007268:Injections, Epidural; D015552:Injections, Intralesional; D017116:Low Back Pain / Q000188:drug therapy* / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000601:surgery; D013122:Spinal Diseases / Q000188:drug therapy* / Q000601:surgery*; D013123:Spinal Fusion / Q000592:standards*; D013256:Steroids / Q000008:administration & dosage
D000777:Anesthetics; D013256:Steroids