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| 22KS-006 |
Effectiveness of balloon neuroplasty in patient with chronic lumbar spinal stenosis accompanying spondylolisthesis
1Department
of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan
College of Medicine, Seoul 05505, Republic of Korea
2Department
of Dental Anesthesiology and Dental Research Institute, School of Dentistry,
Seoul National University, Seoul 03080, Republic of Korea
Background: Degenerative lumbar spondylolisthesis (DLS) is an acquired displacement of a vertebra over the subjacent vertebra and associated with degenerative changes without a disruption/defect in the vertebral ring. Epidural steroid injection (ESI) revealed only short-term improvements [1]. Regarding lumbar spinal stenosis (LSS) with symptoms similar to DLS, there is evidence that percutaneous epidural neuroplasty is more effective than conventional ESI. A recent study revealed that percutaneous epidural neuroplasty was more effective with a balloon catheter than with a Racz catheter [2]. We evaluated the effectiveness of percutaneous epidural balloon neuroplasty in patients with chronic LSS accompanying DLS.
Subjects and Methods: This is retrospective longitudinal cohort study conducted at the pain clinic at Asan Medical Center, Seoul, Republic of Korea. Patients with chronic LSS who underwent percutaneous epidural balloon neuroplasty between January 2014 and December 2018 were included.
Demographic data regarding age, sex, body mass index, diabetes, hypertension, pain duration, location, pain intensity, and medications were retrieved from electronic medical records. For outcome evaluation, pain intensity, medication usage, and physical functional status were collected at 1, 3, and 6 months after the procedure. A generalized estimating equations model was used at the 6-month follow-up. Patients were divided with DLS (Spondylolisthesis group) and those without DLS (No-spondylolisthesis group) to evaluate whether the effects of percutaneous epidural balloon neuroplasty were different.
Results: A total of 826 patients were included (Spondylolisthesis: 433 patients, 52.4%; No-spondylolisthesis: 393 patients, 47.6%). There were statistically significant between-group differences in age, body mass index, hypertension, pain location, and stenosis grading (Table 1). An adjusted analyses revealed a significant improvement in the estimated mean numerical rating scale of pain intensities compared to that at baseline in both groups (P <0.001) (Table 2). Any adverse events that occurred were minor and temporary.
Conclusion: Percutaneous epidural balloon neuroplasty may be an alternative treatment option for patients with chronic LSS regardless of accompanying DLS who have had failed conservative management.
References
1. GarczAlperative spondylolisthesis II: treatment and controversies. Acta Ortop Mex 2020; 34: 433-40.
2. Karm MH, Choi SS, Kim DH, et al. Percutaneous epidural adhesiolysis using inflatable balloon catheter and balloon-less catheter in central lumbar spinal stenosis with neurogenic claudication: a randomized controlled trial. Pain Physician 2018; 21: 593-606.
Subjects and Methods: This is retrospective longitudinal cohort study conducted at the pain clinic at Asan Medical Center, Seoul, Republic of Korea. Patients with chronic LSS who underwent percutaneous epidural balloon neuroplasty between January 2014 and December 2018 were included.
Demographic data regarding age, sex, body mass index, diabetes, hypertension, pain duration, location, pain intensity, and medications were retrieved from electronic medical records. For outcome evaluation, pain intensity, medication usage, and physical functional status were collected at 1, 3, and 6 months after the procedure. A generalized estimating equations model was used at the 6-month follow-up. Patients were divided with DLS (Spondylolisthesis group) and those without DLS (No-spondylolisthesis group) to evaluate whether the effects of percutaneous epidural balloon neuroplasty were different.
Results: A total of 826 patients were included (Spondylolisthesis: 433 patients, 52.4%; No-spondylolisthesis: 393 patients, 47.6%). There were statistically significant between-group differences in age, body mass index, hypertension, pain location, and stenosis grading (Table 1). An adjusted analyses revealed a significant improvement in the estimated mean numerical rating scale of pain intensities compared to that at baseline in both groups (P <0.001) (Table 2). Any adverse events that occurred were minor and temporary.
Conclusion: Percutaneous epidural balloon neuroplasty may be an alternative treatment option for patients with chronic LSS regardless of accompanying DLS who have had failed conservative management.
References
1. GarczAlperative spondylolisthesis II: treatment and controversies. Acta Ortop Mex 2020; 34: 433-40.
2. Karm MH, Choi SS, Kim DH, et al. Percutaneous epidural adhesiolysis using inflatable balloon catheter and balloon-less catheter in central lumbar spinal stenosis with neurogenic claudication: a randomized controlled trial. Pain Physician 2018; 21: 593-606.