Virtual reality and minimal analgesia attenuate pain during spine surgery

We present progress with 17 cases of virtual reality (VR) therapy to reduce pain and anxiety during interventional treatment under radiology guidance on patients diagnosed with intense and chronic back pain with narrow channel syndrome and lumbar disc hernias. Methodology. Patients under informed consent fitted with a head mounted display (HMD), to allow them to navigate in VR scenarios, lie in a prone position. The procedure begins using minimal analgesia with an intravenous single dose with fentanyl 50 mcg without sedation. We infiltrate locally with local anesthesia (lidocaine 1%); depending on the interventional procedure involved. The interventional procedures were: discography with discolysis with ozone, caudal blockages, and foramina blocks. During the procedure, patients navigate VR scenarios created at the Virtual Reality Medical Center in San Diego (Dr. Brenda Wiederhold). At the end of the procedure, patients recover for one to two hours before leaving the Surgical Center. Results. No statistically significant increase in pain ratings from baseline through procedure were noted, however, a significant decrease was noted post-operatively. The attenuation of pain due to VR distraction in 17 patients allowed the procedure to be non-sedative (Midazolam was not used). Conclusions. Advantages of VR therapy include a high degree of patient satisfaction, minimal risk without sedatives, such as midazolam, maintenance of patient's conscious awareness, stress reduction in the patient, stress reduction in the anesthesiologist, and cooperation with the patient. The noninvasive VR equipment used is portable, reliable, and led to a a better patient–physician relationship. VR therapy during pain treatment is an excellent option in the pain clinic. Chronic pain treated with anti-inflammatories administered directly to the spine and local ozone is an area in which the use of VR can significantly reduce pain. With this experience we demonstrate the cost benefit advantage that also offers satisfaction to patients while offering savings to health institutions. No complications were presented.