Background: The combined epidural adhesiolysis with balloon decompression can lead to functional improvement and significant pain relief in patients with lumbar spinal stenosis. However, factors associated with successful responses to balloon adhesiolysis with an inflatable balloon catheter are not known.

Objective and method: We aimed to evaluate the factors associated with the successful responses of the combined epidural adhesiolysis with decompression with an inflatable balloon catheter in patients with lumbar spinal stenosis. In pain clinics of 5 centers in the Republic of Korea, we prospectively collected and evaluated data of 207 patients with chronic lumbar spinal stenosis, who were treated with the combined epidural adhesiolysis and decompression with an inflatable balloon catheter. Successful response 6 months after the procedure was defined as: 1) a decrease of ≥ 50% or ≥ 4 points on the numerical rating scale, and no increase of ODI/MQS and GPES ≥ 4, or 2) a decrease of ≥ 30% or ≥ 2 points on the numerical rating scale, and including one of the following condition: i) decrease of ≥ 30% or ≥ 10 points on ODI, ii) ≥ 5 points on GPES, or iii) no increase of MQS. Logistic regression analysis was performed to determine the factors associated with successful responses to the combined epidural adhesiolysis with balloon decompression

Results: Six months after the balloon adhesiolysis, 92 patients (44.4%) and 115 patients (55.6%) were considered successful responders and non-responders, respectively. There were no significant differences between the two groups in demographic data except for foraminal stenosis grade. Mild foraminal stenosis in responder group was significantly higher than in non-responder group (53.3% vs. 31.3%, P=0.005). Younger age, ODI, and mild lumbar foraminal stenosis were considered as factors associated with the successful response at 6 months after the combined epidural adhesiolysis with balloon decompression in univariate logistic regression analysis. (P<0.2). However, after adjusting for demographic differences for multivariate logistic regression analysis, mild foraminal stenosis was only independently associated with successful responses at 6 months after this procedure (odds ratio=2.829, 95% confidence interval=1.351 results suggest that the combined epidural adhesiolysis with decompression with an inflatable balloon catheter can successfully reduce pain and improve functional status in patients with mild lumbar foraminal stenosis, although it may be applied to patients with moderate or severe stenosis.