脊椎手術後の椎間板性腰痛に対する椎間板内高周波熱凝固法（IDET）の経験
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It is estimated that almost 20% of chronic low back pain (LBP) patient of failed back syndrome (FBS) originates from a painful degenerative intervertebral disc. We present a chronic discogenic LBP patient whose ongoing pain after surgical descectomy was resolved after intradiscal electrothermal therapy (IDET). A 29-year-old woman underwent suffered from severe LBP for almost 2 years after surgical descectomy to the herniation of the L5/S1 disc.Visual analogue scale (VAS) levels of pre-IDET pain severity was rated 80 mm. She could not work for 2 years. The patient was referred to the pain clinic of the Department of Anesthesiology in Shiga University of Medical Science, and diagnosed as L5/S1 discogenic pain by physical examination and discography. The patient underwent L5/S1 IDET.There was a progressive lessening of pain after the IDET. VAS levels reduced from 80 mm to 10 - 30 mm, and the RMDQ (Roland-Morris Disability Questionnaire) score improved from 15 to 1, six month after IDET. L5 - S1 disc protrusion, which was found on the first MRI scan, were resolved in the follow-up MRI scan, 6 months after IDET. The patient reported almost complete pain relief and was able to return to work 12 months after IDET. In our case, IDET alleviated post-surgical chronic discogenic LBP. Although patients who have had prior surgery at the symptomatic level, is not considered to be a indication of IDET, our case suggests that some chronic discogenic pain patients after surgical descectomy to the disc herniation may be successfully treated with IDET.
- 日本疼痛学会の論文
日本疼痛学会 | 論文
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