Adhesiolysis and targeted steroid/local anesthetics injection during epiduroscopy improves pain and sensory nerve dysfunction in patients with chronic sciatica

Purpose. The aim of this study was to evaluate the effect of adhesiolysis followed by the injection of steroid and local anesthetic during epiduroscopy on sensory nerve function, pain and functional disability in patients with chronic sciatica. Methods. Epidural adhesiolysis using epiduroscopy followed by the injection of steroid and local anesthetic were scheduled in 19 patients with chronic sciatica refractory to lumbar epidural block. Sensory nerve function in legs by a series of 2000 (Aβ fibers), 250 (Aδ fibers) and 5 Hz (C fibers) stimuli using current perception threshold (CPT), pain and Roland Morris Disability Questionnaire (RMDQ) scores were assessed before and 1 and 3 months after epiduroscopy. Results. At all frequencies, the CPT values in the affected legs of patients before the epiduroscopy were significantly higher than those in unaffected legs. Epidural adhesiolysis was successfully performed in 16 out of 19 patients. In these patients, the CPT values at 2000 and 250 Hz, pain and RMDQ scores 1 and 3 months after the epiduroscopy were significantly lower than those before the epiduroscopy, while the CPT value at 5 Hz did change. Conclusion. Epidural adhesiolysis followed by the injection of steroid and local anesthetic during epiduroscopy improved pain, functional disability and dysfunction of