A significant improvement of leg and back pain was found in both groups after six months. ODI was significantly improved only in group B in both the six- and 12-month intervals. Back pain at one-year follow-up was only improved in group B.

OBJECTIVE: Prospective observational multicentre two-arm parallel study describing clinical outcome after endoscopic discectomy provided via transforaminal and interlaminar approach. BACKGROUND: Endoscopic lumbar discectomy (ELD) is a percutaneous minimally invasive procedure for the treatment of herniated lumbar discs. Herniations at lumbar intervertebral disc levels of L1/2, L2/3, L3/4 and L4/5 are mostly accessed by the transforaminal (TF) approach. However, due to the anatomic position of the iliac crest, the L5/S1 level might not be reachable by the transforaminal approach, while the interlaminar (IL) percutaneous approach should be a suitable alternative. METHODS: In a prospective observational multicentre clinical trial NCT0274311, we compared the clinical outcomes of two groups of patients who underwent ELD via IL (83) and TF (103) approach. The subjects were followed for 12 months via planned examinations by pain physicians. The levels of leg pain and back pain intensity were assessed by an 11-point numerical ratings scale (NRS). Patient's functional disability was assessed by the Oswestry Disability Index (ODI). RESULTS: Study subjects showed a signifi cant decrease in ODI scores in both groups (p < 0.001) The values of mean preoperative ODI in TF and IL groups were 39.1 ± 15.7 and 43.4 ± 16, respectively. Postoperative values in the latter groups were 14.8 ± 14.9 and 17.5 ± 14.3, respectively. Signifi cantly lower pain scores for leg pain (p<0.001) and back pain (p < 0.001) were also recorded at 12-month follow-ups. CONCLUSION: Because both procedures are strictly percutaneous; they are now more commonly performed by interventional pain physicians as a safe and effective alternative to open surgical spine procedures (Tab.

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Isolated neuropathy of the superficial peroneal nerve (SPN) is a relatively rare type of peripheral neuropathy. It is linked to the mechanical entrapment of the SPN in predisposed locations of its anatomical pathway. Associated clinical findings are insufficient lifting of the latero-dorsal part of the foot, stepping on the lateral border of the foot, and commonly, a strong pain localized in the nerve dermatome.Case report. We describe a case of a 14-year-old female patient with right leg pain lasting 24 months. Repeated neurological examinations with negative findings on electromyography (EMG) were performed. The patient underwent a Steindler surgery for a suspected diagnosis of a heel spur, without any improvement. Despite complex pharmacotherapy, chronic pain developed. The patient was unable to walk, being bound to a wheelchair. Amputation of her lower limb under the knee was also considered. SPN entrapment was diagnosed at a physical examination at EuroPainClinics. Decompression of the SPN under local anaesthesia was performed at the clinic.Results. The symptoms improved immediately after the procedure, and following 2 months of rehabilitation, the patient was completely symptom-free. Her clinical state remains unchanged until this day.Conclusions. SPN entrapment is not a common diagnosis in the group of pain syndromes. Regarding the lower limb, it is imperative to include it on the list of differential diagnoses in cases of pain and functional disorders of the lateral muscle groups of the calf and leg. In the case of SPN entrapment, EMG findings may be negative.

BACKGROUND: Epiduroscopy is a percutaneous endoscopic technique with an interesting diagnostic and therapeutic potential. AIM: The study was aimed to evaluate the effectiveness of this modern minimally invasive method in treating pain together with the accompanying neurological symptoms of patients with a failed back surgery syndrome (FBSS). RESULTS: In the retrospective multicentre clinical study, we monitored the effect of epiduroscopic performance in 40 patients with FBSS before epiduroscopy and after 6 and 12 months. The results of the study indicated a signifi cant improvement in back pain after 6 months, at p<0.05. At the same time, a signifi cant improvement was observed in pain radiating to the lower limbs after 6 and 12 months at p<0.05, as well as a signifi cant improvement in the Oswestry Disability Index of the limbs after 6 months and after 12 months (p<0.05). CONCLUSION: The current summarised results indicate a signifi cant positive effect of epiduroscopy in the treatment of chronic back pain with a reduction in radiating pain to the lower extremities and an increase in patients' quality of life after the procedure (Tab. 2, Fig. 1, Ref. 23).