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| 22KS-024 |
Comparison Endoscopic Epidural Neuroplasty and Percutaneous Epidural Neuroplasty in Low Back Pain and Radicular Pain
1Department of Anesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon, Korea
2Department of Anesthesiology and Pain Medicine, Inha University School of Medicine, Incheon, Korea
Introduction
Endoscopic epidural neuroplasty(EEN) has been conducted for patients with disc herniation since its introduction in 2016, and the advantage is that it can be treated after confirming direct visualization of spinal pathology. In a previous study, EEN and percutaneous epidural neuroplasty(PEN) were performed on patients with herniated lumbar disc, and significant differences were observed in VAS, ODI from 12 weeks after the procedure.
In this retrospective study, we compared VAS and ODI change between the two groups for patients with lumbar heriated disc, spinal stenosis, and postsurgical spinal stenosis 1 and 6 months after the procedure in patients who underwent EEN and PEN.
Materials and Methods
In all patients, the procedure was performed after informed consent was obtained.
From March 2016 to December 2020, patients who visited our pain clinic and had low back pain and radiating pain and had little response to lumbar epidural nerve block and medication were included. 73 patients with EEN and 34 patients with PEN included a total of 107 patients. The degree of pain relief was analyzed through the patient\'s EMR and images during the procedure.
Results
Both EEN and PEN groups showed a statistically significant pain decreased effect (VAS) and ODI up to 6 months after the procedure.
In HLD patients, the group who underwent EEN showed a significant relieves in pain compared to the group that underwent PEN the next day, 1 month, and 6 months after the procedure ( p = 0.021, 0.007. 0.00). In HLD patients, ODI showed a significant difference in pain relief at 1 month and 6 months after the procedure (p < 0.05, 0.05).
In spinal steonosis patients, EEN group showed significant pain reduction at 1 month and 6 months compared to PEN group (p = 0.004, 0.037). In spinal steonosis patients, ODI showed a significant difference in pain reduction 1 month after the procedure (p < 0.05).
In postsurgical spinal steonosis patients, the EEN group showed a significant difference in pain reduction compared to the PEN group only 1 month after the procedure. In postsurgical spinal steonosis patients, ODI showed a significant difference in pain reduction 1 month after the procedure (p < 0.05).
Conclusions
Both EEN and PEN can be effective treatment for patients with back pain and radiating pain.
EEN can be a superior treatment method compared to PEN considering pain relief and pain free interval.
Endoscopic epidural neuroplasty(EEN) has been conducted for patients with disc herniation since its introduction in 2016, and the advantage is that it can be treated after confirming direct visualization of spinal pathology. In a previous study, EEN and percutaneous epidural neuroplasty(PEN) were performed on patients with herniated lumbar disc, and significant differences were observed in VAS, ODI from 12 weeks after the procedure.
In this retrospective study, we compared VAS and ODI change between the two groups for patients with lumbar heriated disc, spinal stenosis, and postsurgical spinal stenosis 1 and 6 months after the procedure in patients who underwent EEN and PEN.
Materials and Methods
In all patients, the procedure was performed after informed consent was obtained.
From March 2016 to December 2020, patients who visited our pain clinic and had low back pain and radiating pain and had little response to lumbar epidural nerve block and medication were included. 73 patients with EEN and 34 patients with PEN included a total of 107 patients. The degree of pain relief was analyzed through the patient\'s EMR and images during the procedure.
Results
Both EEN and PEN groups showed a statistically significant pain decreased effect (VAS) and ODI up to 6 months after the procedure.
In HLD patients, the group who underwent EEN showed a significant relieves in pain compared to the group that underwent PEN the next day, 1 month, and 6 months after the procedure ( p = 0.021, 0.007. 0.00). In HLD patients, ODI showed a significant difference in pain relief at 1 month and 6 months after the procedure (p < 0.05, 0.05).
In spinal steonosis patients, EEN group showed significant pain reduction at 1 month and 6 months compared to PEN group (p = 0.004, 0.037). In spinal steonosis patients, ODI showed a significant difference in pain reduction 1 month after the procedure (p < 0.05).
In postsurgical spinal steonosis patients, the EEN group showed a significant difference in pain reduction compared to the PEN group only 1 month after the procedure. In postsurgical spinal steonosis patients, ODI showed a significant difference in pain reduction 1 month after the procedure (p < 0.05).
Conclusions
Both EEN and PEN can be effective treatment for patients with back pain and radiating pain.
EEN can be a superior treatment method compared to PEN considering pain relief and pain free interval.