Evaluation of adding hyaluronidase to injectate in transforaminal epidural blockade in the management of chronic low back pain

Maintaining low back pain after spinal surgeries is one of the pretty challenging problems in treating patients. Various modalities have been introduced for treatment and one of the most effective ways between them، is steroid and other drugs injection into epidural space. In a double blind RCT study، 25 patient from pain clinic with low backpain due to failed back surgery syndrome were candidate for epidural transforaminal block and divided into case and control groups randomly. The selected drug regimens were as follow: in case group bupivacaine %0. 5، triamcinolone 40mg، hypertonic saline5%، hyaluronidase 1500IU، and in control group stilled water instead of hyaluronidase was used per each nerve root. Pain score، analgesic consumption، neurological examinations and satisfaction were evaluated in recovery and 1، 2، and 4 weeks later. There was no difference in demographic data between 2 groups. Pain score and total analgesic consumption in case group was meaningfully higher 2 and 4 weeks after blockade (p<0. 01). Patient satisfaction was higher in case group. Adding hyaluronidase to transforaminal injectate should be an effective for managingchronic low back pain in failed back surgery syndrome.