S106 European Journal of Pain 2006, Vol 10 (suppl S1) Abstracts, 5th EFIC Congress, Free Presentations

department. While the therapy was going on, her pain scores (VAS) weredecreased below 3 and further disappeared in one month.Conclusion: Brucellosis may present as a nonspecific illness with fever,arthralgia and myalgia like influenza. Despite the lack of diagnosticcriteria, brucellosis should be kept in mind in patients complaining aboutlow back pain especially in endemic areas. Other complaints and historyof the patient like lumbar trauma may confuse us.

396TRANSFORAMINAL ANTERIOR EPIDURAL STEROIDINJECTION VERSUS PERCUTANEUS DISC NUCLEOPLASTY:A PROSPECTIVE STUDY

A. Cimen°, G.K. Talu, N.S. Ozyalcin, S. Erdine. Department of Algology,Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey

Background and Aims: Minimally invasive techniques are commonlyused for the treatment of low-back pain. The aim of this prospective studywas to compare the results of epidural steroid injection with percutaneusnucleoplasty.Methods: A total of 50 patients with low-back pain radiating to thelower extremity associated with contained lumbar disc herniation wererandomly divided into two treatment groups consisting of 25 patients each.In Group I, 80mg of triamcinolone acetate in 5ml of 1% lidocaine wasinjected to the anterior epidural space with the transforaminal approachwhereas percutaneus disc nucleoplasty was applied to the patients inGroup II. The patients were followed-up 1 day, 1 month, 3 months and 6months after the applications. Pain intensity, analgesic use, complicationsand side effects were recorded.Results: Pain intensity and analgesic use were significantly lower at the 1st,3rd, and 6th month follow-ups. The inter-group comparisons did not revealany statistically significant difference. No complications were recorded. 2patients in Group I and 3 patients in Group II complained of back painlasting less than 48 hours.Conclusions: Both treatment methods can be regarded as effective inthe treatment of radicular low-back pain associated with contained discherniations. But we could not demonstrate the superiority of one treatmentmethod over the other by means of clinical outcome, both in the short-and long-term. This is important as the treatment costs are much higherfor nucleoplasty.

397LUMBAR TRANSFORAMINAL EPIDURAL STEROIDINJECTIONS: A PROSPECTIVE SHORT-TERM OUTCOMEANALYSIS

G. De Clerck°, T. Thyssen, A. Kumar, P. Van Wambeke, J. Moonen,B. Morlion. Leuven Algology Centre, UZ Leuven, Leuven, Belgium

Background and Aims: Transforaminal epidural steroid injections (TFE-SIs) are a common therapeutic procedure for lumbosacral radiculopathy.Our objective was to assess short-term outcome after lumbar TFESI in ourcentre.Methods: The 39 patients included had unilateral sciatica confirmed byelectrodiagnostic and radiographic findings. All patients were referred forTFESI. Only patients with a pre-intervention Visual Analogue Scale (VAS)of 4 or more were considered. Duration of symptoms was variable but lessthan 1 year and patients were allowed to continue oral analgesics. Afterinjection of 1mL of contrast medium, a mixture of 1mL Diprophos®

and 2mL lidocaine 1% was injected. Treatment outcome was measuredby scoring a VAS with a range from 0 to 10 and an Oswestry DisabilityIndex (ODI) ranging from 0% to 100%. Outcome measures were collectedbefore and at 3 and 6 weeks after TFESI.Results: VAS (baseline; mean 6.1; SD 1.49) was significantly decreasedat 3 (mean 4.55; SD 2.40; P< 0.001) and at 6 weeks (mean 4.1; SD 2.43;P< 0.001). ODI (baseline; mean 44.4; SD 17.00) was significantly de-creased at 3 (mean 35.4; SD 20.24; P< 0.001) and at 6 weeks (mean 32.2;SD 18.05; P< 0001). Correlation analysis revealed a good correlation ofODI and VAS (R= 0.55; 0.68 and 0.58 respectively).

Conclusions: The decrease of pain intensity by 34% is clinically rele-vant and comparable to data in the literature. The well-established goodcorrelation between ODI and VAS scores is reflected in our results.

398A TYPICAL LOW BACK PAIN PRESENTATION CAUSED BY ANATYPICAL ETIOLOGY

A. Ergin °, T. Toker, O. Yanarates, E. Kurt, M.E. Guzeldemir. ulhaneMilitary Medical Faculty Department of Anesthesiology and ReanimationAnkara/Turkey

Objective: Pain arising in the lumbar region of the spine can be dueto many causes, and, in almost 80% of cases, these causes cannot beestablished certainly. Our case emphasizes that during the evaluation allthe causes, even which are very rare, should bear in mind.Case Report: A 54-year-old woman presented with a 2-month historyof low back pain and sciatica on the right side. Conventional analgesics,physiotherapy and epidural steroid application has failed before, she wassent to our pain clinic. She had tenderness on the right sacroiliac joint, andPatrick-Faber and Ganzlen tests were positive on the right side. Diagnosticfluoroscopy guided sacroiliac joint injection with 2 mL’s of % 2 lidokaindid not produce any relief of symptoms. After the examination of the pelvicregion with ultrasonoghraphy and magnetic resonance imaging (MRI), ithas became clear that septated multilocular hydatic cysts exist along thesciatic nerve. She has undergone an operation and they found multicysticlesions along the sciatic nerve woven to the nerve trace at the surgicalarea. The low back pain disappeared totally after the operation. She wasgiven per oral albendazole for 6 months in order to prevent any recurrenceof the disease. She is still under control per 6 monthly periods withoutany symptom.Conclusion:We should remember hydatid cyst in the differential diagnosisof LBP, especially in the endemic areas, where human hydatidosis stillposes a significant public health problem.

399EFFICACY OF BACK CARE PROGRAM IN CHRONIC BACKPAIN DURING PREGNANCY

E. Ghayem Hasankhani °, M.T. Peivandy, M. Safdari. Mashad Universityof Medical Sciences/Shahid Kamiab Hospital, Mashad, Khorasan, Iran

Introduction: High incidence of pregnant women are expected to sufferfrom back pain during their pregnancy and a large number of them losetheir daily activities because of back pain severity.Aim: To find a solution in reducing back pain during pregnancy in thewomen with chronic back pain.Methods and Materials: 56 patients with chronic back pain were includedin the study, of whom 16 were seen before, 14 in early period (first month)(group A), and 26 in late period (after 4th month) of pregnancy (group B).The study was done between 1999 and 2004. The mean age was 22/1years (18–32-years). All of patients were instructed the general back careprogram at first visit.Results: The pathology of back pain in these patients was as follows:Spondylolisthisis, deformity of the spine, disc hernia, malformation of thespine, and unknown pathology.The group A who were encouraged to begin a back care program hadexcellent – good results (13–20 point of PROLO scale).The group B had fair – poor results (4–12 point), but after beginning ofback care program, they had about 4–8 point recovery.Conclusion: Chronic back pain with every pathology, is not a difficulty inpregnancy, and prevention or reduction of it, is possible with a back careprogram.