Nerve Root Block with Corticosteroids, Hyaluronidase, and Local Anesthetic in the Failed Back Surgery Syndrome (FBSS)

Failed Back Surgery Syndrome (FBSS) 환자에서 Hyaluronidase를 사용한 신경근차단술의 효과

  • Lee, Kyung-Jin (Pain Clinic, Department of Anesthesiology, School of Medicine, Ajou University Hospital) ;
  • Han, Sang-Gun (Pain Clinic, Department of Anesthesiology, School of Medicine, Ajou University Hospital) ;
  • Yoon, Seuk-Hwan (Pain Clinic, Department of Anesthesiology, School of Medicine, Ajou University Hospital) ;
  • Kim, Jin-Soo (Pain Clinic, Department of Anesthesiology, School of Medicine, Ajou University Hospital) ;
  • Lee, Young-Suk (Pain Clinic, Department of Anesthesiology, School of Medicine, Ajou University Hospital)
  • 이경진 (아주대학교 의과대학 마취과학교실 통증클리닉) ;
  • 한상건 (아주대학교 의과대학 마취과학교실 통증클리닉) ;
  • 윤석환 (아주대학교 의과대학 마취과학교실 통증클리닉) ;
  • 김진수 (아주대학교 의과대학 마취과학교실 통증클리닉) ;
  • 이영석 (아주대학교 의과대학 마취과학교실 통증클리닉)
  • Published : 1999.11.30

Abstract

Background: Millions of patients with chronic sciatica are still treated with epidural corticosteroids. The efficacy of epidural corticosteroids remains questionable, especially in the failed back surgery syndrome (FBSS). We studied to evaluate outcome for 10 patients with failed back surgery syndrome treated with spinal nerve root block using corticosteroids, hyaluronidase, and local anesthetics. Methods: The affected nerve roots are localized with the help of fluoroscopy and contrast dye. Local anesthetic diluted in 1,500 U hyaluronidase and 40 mg methylprednisolone is injected. A small retrospective pilot group of 10 patients with FBSS was treated. The success rate is evaluated using a visual analogue scale at 1 week and 3 month interval after the last injection. Results: Initially, 7 patients experienced good pain relief; 5 patients suspained pain relief for 3 months. No complications were observed. Conclusions: This technique is worthwhile for patients with FBSS and where epidural fibrosis is suspected to be the pain origin.

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