PMID- 23615889
OWN - NLM
STAT- MEDLINE
DCOM- 20131108
LR  - 20181202
IS  - 2150-1149 (Electronic)
IS  - 1533-3159 (Linking)
VI  - 16
IP  - 2 Suppl
DP  - 2013 Apr
TI  - Spinal endoscopic adhesiolysis in post lumbar surgery syndrome: an update of 
      assessment of the evidence.
PG  - SE125-50
AB  - BACKGROUND: Post lumbar surgery syndrome refers to pain occurring or present 
      after lumbar surgery. While the causes of pain after lumbar surgery are 
      multi-factorial, scarring is a significant source of that pain. Low back and/or 
      leg pain after lumbar surgery can persist despite appropriate conservative 
      therapy. Spinal endoscopy allows direct visual evaluation of the epidural space, 
      along with mechanical lysis of any adhesions present. STUDY DESIGN: A systematic 
      review of the effectiveness of spinal endoscopic adhesiolysis in post lumbar 
      surgery syndrome. OBJECTIVE: To evaluate and update the effectiveness of spinal 
      endoscopic adhesiolysis in treating post lumbar surgery syndrome. METHODS:   The 
      available literature on spinal endoscopic adhesiolysis in treating post lumbar 
      surgery syndrome was reviewed. The quality assessment and clinical relevance 
      criteria utilized were the Cochrane Musculoskeletal Review Group criteria as 
      utilized for interventional techniques for randomized trials and the criteria 
      developed by the Newcastle-Ottawa Scale criteria for observational studies.The 
      level of evidence was classified as good, fair, and limited or poor based on the 
      quality of evidence developed by the U.S. Preventive Services Task Force 
      (USPSTF). Data sources included relevant literature identified through searches 
      of PubMed and EMBASE from 1966 to September 2012, and manual searches of the 
      bibliographies of known primary and review articles. OUTCOME MEASURES: Pain 
      relief and functional improvement were the primary outcome measures. Other 
      outcome measures were improvement of psychological status, opioid intake, and 
      return to work. Short-term effectiveness was defined as improvement of 12 months 
      or less; whereas, long-term effectiveness was defined 12 months or longer. 
      RESULTS: For this systematic review, 21 studies were identified. Of these, one 
      randomized controlled trial (RCT) and 5 observational studies met the inclusion 
      criteria. Two of the observational studies were excluded because of other 
      methodological issues, despite showing positive outcomes.Using current criteria 
      for successful outcomes, these studies indicate that there is fair evidence for 
      the effectiveness of spinal endoscopy in the treatment of persistent low back 
      and/or leg pain in post lumbar surgery syndrome. LIMITATIONS:   The limitations 
      of this systematic review include the paucity of literature. CONCLUSIONS: The 
      evidence is fair that spinal endoscopy is effective in the treatment of post 
      lumbar surgery syndrome.
FAU - Helm, Standiford
AU  - Helm S
AD  - The Helm Center for Pain Management, Laguna Hills, CA 92637, USA.
FAU - Hayek, Salim M
AU  - Hayek SM
FAU - Colson, James
AU  - Colson J
FAU - Chopra, Pradeep
AU  - Chopra P
FAU - Deer, Timothy R
AU  - Deer TR
FAU - Justiz, Rafael
AU  - Justiz R
FAU - Hameed, Mariam
AU  - Hameed M
FAU - Falco, Frank J E
AU  - Falco FJ
LA  - eng
PT  - Journal Article
PT  - Review
PT  - Systematic Review
PL  - United States
TA  - Pain Physician
JT  - Pain physician
JID - 100954394
SB  - IM
MH  - Endoscopy/*methods
MH  - Humans
MH  - Injections, Epidural
MH  - Low Back Pain/*surgery
MH  - Lumbosacral Region/surgery
MH  - Pain Measurement
MH  - Postoperative Complications/*physiopathology/surgery
MH  - Randomized Controlled Trials as Topic
MH  - Tissue Adhesions/*therapy
EDAT- 2013/05/03 06:00
MHDA- 2013/11/10 06:00
CRDT- 2013/04/26 06:00
PHST- 2013/04/26 06:00 [entrez]
PHST- 2013/05/03 06:00 [pubmed]
PHST- 2013/11/10 06:00 [medline]
PST - ppublish
SO  - Pain Physician. 2013 Apr;16(2 Suppl):SE125-50.