The Korean Journal of Pain

  • 제34권3호
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  • Pages.346-368
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  • 2021
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  • 2005-9159(pISSN)
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  • 2093-0569(eISSN)
대한통증학회 (The Korean Pain Society)
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The role of percutaneous neurolysis in lumbar disc herniation: systematic review and meta-analysis

  • Manchikanti, Laxmaiah (Pain Management Centers of America) ;
  • Knezevic, Emilija (University of Illinois at Urbana-Champaign, College of Liberal Arts and Sciences) ;
  • Knezevic, Nebojsa Nick (Advocate Illinois Masonic Medical Center and College of Medicine, University of Illinois) ;
  • Sanapati, Mahendra R. (Pain Management Centers of America) ;
  • Kaye, Alan D. (LSU Health Sciences Center, Shreveport, Ochsner Shreveport Hospital and Pain Clinic Feist-Wieller Cancer Center) ;
  • Thota, Srinivasa (Pain Management Centers of America) ;
  • Hirsch, Joshua A. (Massachusetts General Hospital and Harvard Medical School)
  • 투고 : 2021.04.30
  • 심사 : 2021.05.28
  • 발행 : 2021.07.01
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초록

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 non-randomized studies, the evidence level is II for percutaneous neurolysis in managing lumbar disc herniation.

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과제정보

The authors wish to thank Bert Fellows, MA, Director Emeritus of Psychological Services at Pain Management Centers of America, for manuscript review, and Tonie M. Hatton and Diane E. Neihoff, transcriptionists, for their assistance in preparation of this manuscript.

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피인용 문헌

  1. Comments on "The role of percutaneous neurolysis in lumbar disc herniation: systematic review and meta-analysis" vol.35, pp.1, 2021, https://doi.org/10.3344/kjp.2022.35.1.124
  2. Outcomes of epidural steroids following percutaneous transforaminal endoscopic discectomy: a meta-analysis and systematic review vol.35, pp.1, 2021, https://doi.org/10.3344/kjp.2022.35.1.97