Outpatient percutaneous and endoscopic surgery in interventional pain management.

The evolution of interventional pain management from inception through the present is examined. Increasing demand from patients, referring physicians and third party payors for proven interventions which provide long-term functional relief of symptoms or primary correction of common spinal pain syndromes is discussed. The role of current palliative therapy as compared to the proven clinical validity of outpatient percutaneous and endoscopic spinal surgical techniques is reviewed. Practitioners are encouraged to transition from the use of spinal injections and narcotics of unproven benefit to percutaneous and endoscopic spinal intervention as primary therapy of herniated lumbar disc, discogenic spinal pain, and lumbar spinal stenosis in appropriately selected patients. SD, Expenditures and health status among adults with back and neck problems.