Liječnički vjesnik, Vol. 135 No. 7-8, 2013.
Professional paper
FIRST GUIDELINES OF CROATIAN INTEREST GROUP IN DIAGNOSING AND TREATING LOWER BACK AND RADICULAR PAIN USING MINIMALLY INVASIVE DIAGNOSTIC AND THERAPEUTIC PROCEDURES
Karlo Houra
Darko Perović
Dražen Kvesić
Ivan Radoš
Damir Kovač
Leonardo Kapural
Abstract
Low back and radicular pain recently became a major public health problem. Medical expenses in general, and surgical procedures associated with overall care for the lower back pain are high and growing. Furthermore, these two chronic pain conditions are also leading causes for missed workdays. Degenerative changes of the intervertebral disc, facet joints, sacroiliac joint or disc herniation as described during imaging diagnostics may or may not be the cause of patients’ lower back pain. Diagnostic blocks often precede further interventions in order to confirm or dispute a source of the lower back pain. Chronic lower back pain caused by painful intervertebral disc should be treated using biacuplasty. If the pain of the lumbar spine is caused by facet joints or sacroiliac joint, patient can be offered neuroablative procedures using radiofrequency. In cases where the low back and radicular pain are caused by the central and foraminal spinal stenosis patients are advised epidural steroid injections, unless claudications are present. Patients suffering from the chronic radicular pain may be treated with various nucleoplasty procedures or they may be offered percutaneous radiofrequent neuromodulation. The purpose of above advised procedures is to relieve patients’ pain, allow optimal physical therapy, and improved functional capacity, consequently providing better quality of life
Keywords
Low back pain – etiology, diagnosis, surgery; Radiculopathy – etiology, diagnosis, surgery; Surgical procedures, minimally invasive – methods; Practice guidelines as topic; Croatia
Hrčak ID:
172482
URI
Publication date:
26.8.2013.
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