Epiduroscopy: Review of technique and results

Back pain is a common medical problem with significant impact on society. It is estimated that 80% of adults in USA have back pain at some point in their life. It leads to over $ 24 billion per year in direct medical costs. In 95% cases, the symptoms subside without treatment within 3 months. The rest (5%) require extensive, expensive diagnostic work-up and treatment. Surgical treatment, often repeated, although able to release stenotic changes, tends to create new scar tissue. Unfortunately, from 40% to 80% of these patients experience persistent pain - referred to as postlaminectomy syndrome (Manning and Rowlingson, 1998; North et al., 1991). Introduction of epiduroscopy into clinical practice has revolutionized the visualization of the epidural space and offered new options in the treatment of postlaminectomy syndrome. The authors describe the technique and demonstrate the image obtained during the procedure. The outcome of epidural steroid injections under epiduroscopic guidance, in 22 patients, is presented.