Epidural neuroplasty versus physiotherapy to relieve pain in patients with sciatica: a prospective randomized blinded clinical trial.
BACKGROUND
Epidural neuroplasty seems to be one of the promising minimally invasive techniques for adhesiolysis in patients with chronic sciatica with or without low back pain. However, because no data exist from randomized studies the aim was to investigate whether this procedure is superior to conservative treatment with physiotherapy.


METHODS
A total of 99 patients with chronic low back pain were enrolled in this study and randomly assigned into either a group with physiotherapy (n = 52) or a second group undergoing epidural neuroplasty (n = 47). Patients were assessed before and 3, 6, and 12 months after treatment by a blinded investigator.


RESULTS
After 3 months, the visual analog scale (VAS) score for back and leg pain was significantly reduced in the epidural neuroplasty group, and the need for pain medication was reduced in both groups. Furthermore, the VAS for back and leg pain as well as the Oswestry disability score were significantly reduced until 12 months after the procedure in contrast to the group that received conservative treatment.


CONCLUSIONS
Epidural neuroplasty results in significant alleviation of pain and functional disability in patients with chronic low back pain and sciatica based on disc protrusion/prolapse or failed back surgery on a short-term basis as well as at 12 months of follow-up.
Veihelmann
Andreas
A
Department of Orthopaedics, Ludwig Maximilians University of Munich, Munich, Germany.
Devens
C
C
Trouillier
H
H
Birkenmaier
C
C
Gerdesmeyer
L
L
Refior
H J
HJ
D000328:Adult; D000368:Aged; D000577:Amides / Q000008:administration & dosage; D000779:Anesthetics, Local / Q000008:administration & dosage; D002908:Chronic Disease; D004338:Drug Combinations; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D017116:Low Back Pain / Q000534:rehabilitation / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D026741:Physical Therapy Modalities; D011446:Prospective Studies; D000077212:Ropivacaine; D012585:Sciatica / Q000534:rehabilitation*; D014221:Triamcinolone / Q000008:administration & dosage
D000577:Amides; D000779:Anesthetics, Local; D004338:Drug Combinations; D005938:Glucocorticoids; D014221:Triamcinolone; D000077212:Ropivacaine