Percutaneous Pain Procedures in Patients Who Underwent Lumbar Disc Herniation Surgery: Is It an Important Tool in the Management of Post-Surgical Ongoing Pain?

Abstract

Treatment of ongoing pain in patients undergoing disc surgery is extremely difficult, and there is no consensus. Our study aimed to evaluate the efficacy of percutaneous pain interventions in these patients. We retrospectively analyzed 48 patients with persistent / recurring complaints who underwent lumbar disc surgery (LDS) and were treated with percutaneous interventions. They were grouped into recurrent disc herniations (RDHs) and other discovertebral pathologies (ODVP). Moreover, patients were evaluated as those who received transforaminal injection (TFI) with facet blockage (FB) and who received both caudal injection (CI) and TFI in addition to FB. Patients were evaluated using Oswestry Disability Index (ODI) and visual analog scale (VAS). Between the recurrent and ODVP groups, preoperative, 1 h postoperative, and 6 mo postoperative ODI (p = 0.867, p = 0.055, p = 0.892) and VAS (p = 0.902, p = 0.136, p = 0.462) scores did not show a statistically significant difference, respectively. Additionally, in the comparison of patients who underwent FB+TFI+CI and only FB+TFI, there was no statistically significant correlation between preoperative and 6 mo postoperative ODI (p = 0.284) and VAS (p = 0.248) scores in both recurrent and ODVP groups, respectively. The success rates at the 3rd and 6th mo of patients with RDH and ODVP were 47.61% (10/21) and 42.85% (9/21) and 70.37% (19/27) and 63.96% (17/27), respectively. There was no statistically significant difference in ODI and VAS scores between recurrent and ODVP groups. The clinical success rate was numerically better in the ODVP group. Thus, we suggest that co-administration of TFI and CI did not significantly contribute to our clinical outcome.