Background: The combined epidural adhesiolysis with balloon decompression can lead to functional improvement and significant pain relief in patients with lumbar spinal stenosis. However, it has not been evaluated that the effectiveness of the balloon adhesiolysis in patients with post lumbar surgery syndrome.

Objective and method: We aimed to evaluate the effectiveness of the combined epidural adhesiolysis with decompression with an inflatable balloon catheter in patients with post lumbar surgery syndrome. This study was performed in 151 patients with post lumbar surgery syndrome who suffered from chronic (at least 3 months) lumbar radicular pain with or without lower back pain. We retrospectively collected and analyzed data of 151 patients with post lumbar surgery syndrome, 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, 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

Results: The percentage of successful responders was 31.8%, 24.5%, and 21.9% of patients at 1, 3, and 6 months, respectively. A single combined treatment of percutaneous epidural adhesiolysis and balloon decompression with a ZiNeu catheter provided pain relief but not functional improvement in patients with chronic refractory lumbar spinal stenosis.

Conclusion: The combined epidural adhesiolysis and balloon decompression with a ZiNeu catheter led to significant pain relief in a subset of patients with post lumbar surgery syndrome. The combined epidural adhesiolysis and balloon decompression may be a useful modality to manage patients with post lumbar surgery syndrome, although it can not be expected to improve the functional status.