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Revista de la Sociedad Española del Dolor
versão impressa ISSN 1134-8046
Resumo
CARDONA, G. et al. Clinical/radiography correlation of epidural fibrosis in postlaminectomy syndrome by epidurography. Rev. Soc. Esp. Dolor [online]. 2010, vol.17, n.4, pp.196-201. ISSN 1134-8046.
Introduction: Epidurography is an invasive technique that evaluates deformities and eventual occupation of the epidural space, besides being easy to perform, reliable and inexpensive, is part of the management algorithm of post laminectomy syndrome. Objective: To verify whether the location of epidural fibrosis correlates with the clinical picture present in patients with post-laminectomy syndrome. Material and methods: We included 30 patients with a diagnosis of lumbar post-laminectomy syndrome, divided into two groups: Group A (n=15) patients with low back pain and neuropathic unilateral pelvic limb pain, Group B (n=15) patients with low back and bilateral neuropathic pain. The procedure was performed in prone position by fluoroscopic caudal approach. The epidurography was performed by injecting contrast medium Ioversol 63%, methylprednisolone acetate and lidocaine 2%. We associated the location of the fibrosis with the clinical picture and assessed pain intensity using a visual analogue scale (VAS) before the procedure, at 2 and 4 weeks afterwards. Results: Of the total population, 53.3% (16) correlated the clinical/radiographic picture, this was not statistically significant (p=0.259). In relation to the initial VAS, there was a significant decrease at 2 weeks of performing the procedure (p=0.0001). Conclusion: The diagnostic epidurography was not useful when attempting to correlate the site of epidural fibrosis with the clinical presentation in patients with post-laminectomy syndrome.
Palavras-chave : Post-laminectomy syndrome; Epidurography; Epidural fibrosis.