CT-gesteuerte Schmerztherapie des spezifischen Rückenschmerzes: Bandscheibenschädigung vs. ossäre Degeneration

BACKGROUND: Back pain is common and leads the patient to the radiologist both for diagnosis and in specific cases for therapy. OBJECTIVES: The current study compares the pain-reducing effect of microinvasive computed tomography (CT)-guided pain therapy for specific back pain caused by herniated discs or spondylarthrosis. MATERIALS AND METHODS: Over a period of 3.3 years, a total of 239 patients were included, in whom 686 CT-guided periradicular therapies (PRT) and 264 CT-guided facet joint therapies (FAC) were performed. In all patients, the pain score was determined using a visual analog pain scale (VAS) before the intervention, during the course of treatment and at the end of treatment. Finally, treatment success was correlated to the type of treatment performed and to the morphological changes present. RESULTS: Both groups showed good improvement of pain under treatment (74% of the PRT patients and 60% of the FAC patients). Patients who underwent PRT showed an average improvement in pain score of 3.1, while those who underwent FAC showed an average improvement of 2.1. The efficacy of FAC was dependent on the degree of degenerative changes present. The more extensive the proven degeneration was in the treated segment, the more interventions were necessary for a good treatment response. CONCLUSION: CT-guided PRT and CT-guided FAC both lead to a good reduction of pain symptoms. In comparison, PRT achieves significantly higher pain reduction than FAC.