Lysis of adhesions and epidural injection of steroid/local anaesthetic during epiduroscopy potentially alleviate low back and leg pain in elderly patients.

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Lysis of adhesions and epidural injection of steroid/local anaesthetic during epiduroscopy potentially alleviate low back and leg pain in elderly patients with lumbar spinal stenosis† Igarashi T. , Hirabayashi Y. , Seo N. , Saitoh K. , Fukuda H. , Suzuki H. British Journal of Anaesthesia Volume 93, Issue 2, Pages 181-187 (August 2004) DOI: 10.1093/bja/aeh201 Copyright © 2004 British Journal of Anaesthesia Terms and Conditions

Fig 1 Proportions of patients with various epiduroscopic findings in the monosegmental and multisegmental groups. Dotted bars indicate score 1 (none or extremely small), shaded bars indicate score 2 (moderate) and solid bars indicate score 3 (considerable). Significant differences between the groups were found in the median values for amount of fatty tissue and degree of vascularity. No significant differences were found between the groups in the median values for the amount of fibrous connective tissue and degree of adhesion. *P<0.05. British Journal of Anaesthesia 2004 93, 181-187DOI: (10.1093/bja/aeh201) Copyright © 2004 British Journal of Anaesthesia Terms and Conditions

Fig 2 Photographs (top) and schematic drawings (bottom) of the epidural space in a 65-yr-old woman from the monosegmental group. D=dura mater; F=fatty tissue; V=blood vessels; C=fibrous connective tissue; N=nerve root. Fine blood vessels formed complex vascular networks in the fatty and fibrous connective tissues (a). Note the congestion of the fatty and connective tissues around the left L5 nerve root (b). British Journal of Anaesthesia 2004 93, 181-187DOI: (10.1093/bja/aeh201) Copyright © 2004 British Journal of Anaesthesia Terms and Conditions

Fig 3 Photographs (top) and schematic drawings (bottom) of the epidural space in a 75-yr-old woman from the multisegmental group. D=dura mater; V=blood vessels; C=fibrous connective tissue; N=nerve root. Fatty tissue was not detected at this L4–5 vertebral level. Stretched fibrous connective tissue with reduced vascularity was seen in the epidural space (a). The perineural tissue of the right L5 nerve root was ischaemic (b). British Journal of Anaesthesia 2004 93, 181-187DOI: (10.1093/bja/aeh201) Copyright © 2004 British Journal of Anaesthesia Terms and Conditions

Fig 4 Changes in VAS scores for low back (upper panel) and leg (lower panel) symptoms. Open boxes, monosegmental group; grey boxes, multisegmental group. In the box and whisker plots, the horizontal line within the box represents the median value and the top and bottom boundaries of the box represent the 25th and 75th percentiles, respectively. *P<0.05 compared with the value before epiduroscopy; †P<0.05 compared between the two groups. British Journal of Anaesthesia 2004 93, 181-187DOI: (10.1093/bja/aeh201) Copyright © 2004 British Journal of Anaesthesia Terms and Conditions