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| 21KF-041 |
Effectiveness of epidural balloon neuroplasty in patients with chronic spinal stenosis accompanying redundant nerve root
Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea1
Background: Redundant nerve root (RNR) is found in chronic lumbar spinal stenosis and has been reported to be ineffective in conventional treatment. Recently, the epidural balloon neuroplasty has been shown to be effective in patients who experience refractory pain from epidural steroid injection. This study aimed to evaluate the effectiveness of epidural balloon neuroplasty in patients with chronic spinal stenosis accompanying RNR.
Methods: We analyzed 793 patients who underwent epidural balloon neuroplasty from January 2014 to December 2018. The patients were divided into two groups, those with RNR group and non-RNR group. The generalized estimation equations (GEE) model was used in the statistical analysis to evaluate the effectiveness of the epidural balloon neuroplasty in groups with and without RNR based on improvement of numeric rating scale (NRS), medication quantification scale (MQS), and physical functional status at 1, 3 and 6 months after the procedure.
Results: In both the groups, there were significant improvement in the NRS and physical function status throughout the study period, and no significant improvement in MQS. When the back and leg pain scores were compared between the two groups using GEE model, no significant differences that affected the changes in NRS scores were detected throughout the study period except leg pain score at 1 month (p = 0.016). When the physical functional status was compared between the two groups using GEE model, there were significant estimated differences at 3 months (p = 0.001), whereas no significant differences at 1 and 6 months. There were a total 15 (1.9%) complications among study patients (n = 793). There were no significant differences in complications between the two groups.
Conclusion: The epidural balloon neuroplasty was effective in improving pain intensity and physical function status in patients with chronic spinal stenosis accompanying RNR.
Reference
1.Marques CJ, Hillebrand H, Papavero L. The clinical significance of redundant nerve roots of the cauda equina in lumbar spinal stenosis patients: A systematic literature review and meta-analysis. Clin Neurol Neurosurg. 2018;174:40-47.
2.Ozturk AK, Gokaslan ZL. Clinical significance of redundant nerve roots of the cauda equina. World Neurosurg. 2014;82:e717-718.
Methods: We analyzed 793 patients who underwent epidural balloon neuroplasty from January 2014 to December 2018. The patients were divided into two groups, those with RNR group and non-RNR group. The generalized estimation equations (GEE) model was used in the statistical analysis to evaluate the effectiveness of the epidural balloon neuroplasty in groups with and without RNR based on improvement of numeric rating scale (NRS), medication quantification scale (MQS), and physical functional status at 1, 3 and 6 months after the procedure.
Results: In both the groups, there were significant improvement in the NRS and physical function status throughout the study period, and no significant improvement in MQS. When the back and leg pain scores were compared between the two groups using GEE model, no significant differences that affected the changes in NRS scores were detected throughout the study period except leg pain score at 1 month (p = 0.016). When the physical functional status was compared between the two groups using GEE model, there were significant estimated differences at 3 months (p = 0.001), whereas no significant differences at 1 and 6 months. There were a total 15 (1.9%) complications among study patients (n = 793). There were no significant differences in complications between the two groups.
Conclusion: The epidural balloon neuroplasty was effective in improving pain intensity and physical function status in patients with chronic spinal stenosis accompanying RNR.
Reference
1.Marques CJ, Hillebrand H, Papavero L. The clinical significance of redundant nerve roots of the cauda equina in lumbar spinal stenosis patients: A systematic literature review and meta-analysis. Clin Neurol Neurosurg. 2018;174:40-47.
2.Ozturk AK, Gokaslan ZL. Clinical significance of redundant nerve roots of the cauda equina. World Neurosurg. 2014;82:e717-718.
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