Researchers from the Texas Tech University Health Sciences Center announced encouraging results from a new interventional procedure to treat chronic low back pain. The work was presented at the American Society of Regional Anesthesia and Pain Medicine’s 13th annual pain medicine meeting. The PACIF (Percutaneous Ablation, Curettage and Inferior Foraminotomy) procedure was developed by the team after noticing that the majority of their patients’ low back pain could be reproduced in the L4-L5 region of the spine. Epiduroscopy of the area suggested that the likely source of the pain was not the nerve roots or disks, and that it might be a “sensitization of a peridural membrane in the suprapendicular area of the lumbar vertebral.” The researchers found that targeting this membrane helped to relieve pain, even for some patients who had chronic pain for more than five years.
Study author Hemmo Bosscher, MD, describes the PACIF procedure as safe and minimally invasive, taking about 10 minutes to perform, and that he has not observed any complications. A retrospective study of 77 patients with chronic low back pain was conducted to investigate the safety and efficacy of the PACIF procedure. Patients received either an external (using the dilator) or internal (using just the scope) PACIF treatment and were followed up three months later to measure pain relief, functional improvement, reduction in pain medication and willingness to repeat the procedure. The study found that 73% of patients in the completed PACIF group reported excellent or good pain relief at the three-month follow-up, and that the external technique may be more effective. Functional improvement was 57% in the external group versus 38% in the internal group. Pain medication use fell by 47% and 23%, respectively. Noting the lack of control subjects in the study, the researchers also suggest further investigation. Read a news story about the procedure and initial study here.