BACKGROUND: Epiduroscopy is a well-established diagnostic and to certain level therapeutic tool in complex situations, where conventional methods such as magnetic resonance imaging (MRI) lack power or resolution to detect pathological changes. Such a situation is primarily failed back surgery syndrome (FBSS) but also radicular pain without surgery. The aim of this study was to determine the effectiveness of epiduroscopic treatment in patients with FBSS. METHODS: A total of 79 patients with FBSS were randomized into 2 groups. The first group underwent epiduroscopy and received mechanical lysis of adhesions only, the second group received also medication into the epidural space (methylprednisolone and hyaluronidase). Patients were subsequently followed for 12 months, with evaluation also after 6 months post-epiduroscopy. Patients were checked in terms of mobility, self-care, usual activities, pain/discomfort and anxiety/depression as defined in the 5‑dimensional EQ-5D-5L questionnaire and to asses suitability of this questionnaire in chronic pain states. Data were collected using EQ-5D-5L questionnaire and also quality of life (QoL) questionnaire. RESULTS: In the terms of ability to walk (dimension mobility) and also ability to do housework, study or leisure activities (dimension usual activity) patients improved in both groups after 6 and 12 months after epiduroscopy. In pain dimension there was improvement mainly after 6 months which correlated also with self-care dimension and quality of life self-assessment. Results in anxiety/depression dimension were mixed. CONCLUSION: Epiduroscopy appears to be a beneficial procedure for both patient groups, especially after 6 months, with some benefit remaining after 12 months. The EQ-5D-5L questionnaire seems to be a suitable and comprehensive way to assess patient health in chronic pain states.

1st Clinic of Anaesthesiology and Intensive Care Medicine Louis Pasteur University Hospital SNP 1 040 11 Košice Slovakia

Clinic of Anaesthesiology and Intensive Care Medicine East Slovak Institute of Cardiovascular Disease Ondavská 8 040 11 Košice Slovakia

Department of Cardiac Surgery East Slovak Institute of Cardiovascular Disease Ondavská 8 040 11 Košice Slovakia

Department of Medical and Clinical Biochemistry Faculty of Medicine Pavol Jozef Šafárik University Trieda SNP 1 040 66 Košice Slovakia

Europainclinics Kominárska 21 5 831 04 Bratislava Slovakia

Europainclinics Kominárska 21 5 831 04 Bratislava Slovakia Europainclinics Starochodovská 1750 149 00 Prague 4 Czech Republic Europainclinics Štefánikova 1599 82 085 01 Bardejov Slovakia

Europainclinics Starochodovská 1750 149 00 Prague 4 Czech Republic

Institute of Measurement Science Slovak Academy of Sciences Dúbravská cesta 9 841 04 Bratislava Slovakia

Kent Institute of Medicine and Surgery Newnham Court Way ME14 5FT Bearsted Kent UK

Poliklinika Terasa Europainclinics Toryská 1 040 11 Košice Slovakia

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$a BACKGROUND: Epiduroscopy is a well-established diagnostic and to certain level therapeutic tool in complex situations, where conventional methods such as magnetic resonance imaging (MRI) lack power or resolution to detect pathological changes. Such a situation is primarily failed back surgery syndrome (FBSS) but also radicular pain without surgery. The aim of this study was to determine the effectiveness of epiduroscopic treatment in patients with FBSS. METHODS: A total of 79 patients with FBSS were randomized into 2 groups. The first group underwent epiduroscopy and received mechanical lysis of adhesions only, the second group received also medication into the epidural space (methylprednisolone and hyaluronidase). Patients were subsequently followed for 12 months, with evaluation also after 6 months post-epiduroscopy. Patients were checked in terms of mobility, self-care, usual activities, pain/discomfort and anxiety/depression as defined in the 5‑dimensional EQ-5D-5L questionnaire and to asses suitability of this questionnaire in chronic pain states. Data were collected using EQ-5D-5L questionnaire and also quality of life (QoL) questionnaire. RESULTS: In the terms of ability to walk (dimension mobility) and also ability to do housework, study or leisure activities (dimension usual activity) patients improved in both groups after 6 and 12 months after epiduroscopy. In pain dimension there was improvement mainly after 6 months which correlated also with self-care dimension and quality of life self-assessment. Results in anxiety/depression dimension were mixed. CONCLUSION: Epiduroscopy appears to be a beneficial procedure for both patient groups, especially after 6 months, with some benefit remaining after 12 months. The EQ-5D-5L questionnaire seems to be a suitable and comprehensive way to assess patient health in chronic pain states.

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$a Witkovsky, Viktor $u Institute of Measurement Science, Slovak Academy of Sciences, Dúbravská cesta 9, 841 04, Bratislava, Slovakia.

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$a Mláka, Juraj $u Poliklinika Terasa, Europainclinics, Toryská 1, 040 11, Košice, Slovakia.

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$a Poliak, Ľubomír $u Europainclinics, Kominárska 21/5, 831 04, Bratislava, Slovakia.

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