Advances in interventionist techniques to increase safety

Abstract

Lumbosciatic syndrome is one of the most frequent pathologies in the Chronic Pain clinical practice, being postlaminectomy syndrome and lumbar spinal stenosis two of its major causes. The treatment of these two syndromes represent a challenge for the treating physician, because in a high number of patients they don´t respond to pharmacological therapy or to interventional techniques. When the conservative treatment and the minimally invasive procedures fail to treat the lumbosciatic pain, the epiduroscopy becomes one of the indicated techniques, not only as a diagnostic tool, but as a specific treatment implement that allows the release of epidural fibrosis or the elimination of part of the hypertrophied flavum ligament. In this paper we present a novelty in the use of this therapy, which we consider an important advance to increase the safety of the technique, because of the possibility to locate noble tissue in the epidural space by applying sensitive and motor stimulation before makig any definitive treatment, this allows to differentiate between noble tissue, which we aim to preserve, and fibrosis o ligamentum flavum, which we pretend to eliminate.