Interventional Techniques for Managment of Chronic Low Back Pain

Identify the efficacy of difference procedures of imaging guidance for needles for interventional treatments of low back pain (LBP) associated with sciatica and to study results and satisfaction of the patients between different groups.

Inclusion Criteria:Patients with chronic radicular low back pain with unilateral or bilateral sciatica that persisted for more than 6 months and failed medical treatment for 6 weeks.Pain exacerbates by leaning forward and flexion of the body with numbness and tingling in the legs.Visual analog scale (VAS) of pain severity ≥ 5 related specifically to the daily LBP.Patient develops calf and leg pain of leg raising test.No neurological motor deficitsExclusion Criteria:Evidance of progressive motor neurological deficits.Magnetic resonance imaging show evidence of > 3 degenerated discs.Intervertebral disc herniation ≥ 4 mm, disc sequestration, extrusion, disc space collapse or spondylolisthesis at the symptomatic level.Moderate to severe central spinal canal or foraminal stenosisPrior lumbar surgery of any kind at the same treatment levelSpinal fractures, deformities, infection or tumors.History of uncontrolled coagulopathy or uncontrollable bleedingPatients with psychotic illness, advanced hepatic, uncontrolled diabetic patients.Current pregnancy, recent delivery (within 3-months of consent), or the intent of becoming pregnant during the study period.Local sepsis or skin inflammatory in the back region.Patients with red flags.Neurologic findings (Fecal or urinary incontinence and cauda equina syndrome).Persistent fever (infection).Prolonged use of corticosteroids.Pregnancy.