Interventional pain management: when/what therapies are best for low back pain.
OBJECTIVE
The aim of this article is to inform an interested audience on novel minimally invasive and percutaneous interventional options for reduction of lower back pain.


RESULTS
Numerous percutaneous and minimally invasive techniques for treatment of lower back pain were introduced recently. To accumulate sufficient clinical evidence in order to either dismiss or accept the new treatment modalities requires years of delay. Presented here are novel percutaneous procedures to treat discogenic pain, radiculopathies, lumbar facet syndrome, painful compressive vertebral fractures, myofascial pain and postlaminectomy syndrome. Data on efficacy of those procedures available from limited case series reports, retrospective studies and a few prospective trials are reviewed.


CONCLUSIONS
There is a wide variety of techniques introduced recently in pain management of the lower back. Some of those procedures may serve as a definite treatment; others may significantly enhance or facilitate conservative management. Careful selection of the patients may significantly improve the success rates of these procedures.
Pain Management Department, The Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA. Kapural@ccf.org
Leonardo
L
Kapural
Joshua
J
Goldner