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A Novel Balloon-Inflatable Catheter for Percutaneous Epidural Adhesiolysis and Decompression

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초록

Epidural adhesions cause pain by interfering with the free movement of the spinal nerves and increasing neural sensitivity as a consequence of neural compression. To remove adhesions and deliver injected drugs to target sites, percutaneous epidural adhesiolysis (PEA) is performed in patients who are unresponsive to conservative treatments. We describe four patients who were treated with a newly developed inflatable balloon catheter for more effective PEA and relief of stenosis. In the present patients, treatments with repetitive epidural steroid injection and/or PEA with the Racz catheter or the NaviCath did not yield long-lasting effects or functional improvements. However, PEA and decompression with the inflatable balloon catheter led to maintenance of pain relief for more than seven months and improvements in the functional status with increases in the walking distance. The present case series suggests that the inflatable balloon catheter may be an effective alternative to performing PEA when conventional methods fail to remove adhesions or sufficiently relieve stenosis.

Abstract

Epidural adhesions cause pain by interfering with the free movement of the spinal nerves and increasing neural sensitivity as a consequence of neural compression. To remove adhesions and deliver injected drugs to target sites, percutaneous epidural adhesiolysis (PEA) is performed in patients who are unresponsive to conservative treatments. We describe four patients who were treated with a newly developed inflatable balloon catheter for more effective PEA and relief of stenosis. In the present patients, treatments with repetitive epidural steroid injection and/or PEA with the Racz catheter or the NaviCath did not yield long-lasting effects or functional improvements. However, PEA and decompression with the inflatable balloon catheter led to maintenance of pain relief for more than seven months and improvements in the functional status with increases in the walking distance. The present case series suggests that the inflatable balloon catheter may be an effective alternative to performing PEA when conventional methods fail to remove adhesions or sufficiently relieve stenosis.

참고문헌 (20)

  1. Berthelot JM, "The role for radicular veins in nerve root pain is underestimated : limitations of imaging studies", Joint Bone Spine, 78, pp.115~117 (2011)
  2. Cooper RG, "Herniated intervertebral disc-associated periradicular fibrosis and vascular abnormalities occur without inflammatory cell infiltration", Spine (Phila Pa 1976), 20, pp.591~598 (1995)
  3. Kobayashi S, "Effect of mechanical compression on the lumbar nerve root: localization and changes of intraradicular inflammatory cytokines, nitric oxide, and cyclooxygenase", Spine (Phila Pa 1976), 30, pp.1699~1705 (2005)
  4. Anderson SR, "Evolution of epidural lysis of adhesions", Pain Physician, 3, pp.262~270 (2000)
  5. Armon C, "Assessment: use of epidural steroid injections to treat radicular lumbosacral pain: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology", Neurology, 68, pp.723~729 (2007)
  6. 홍지희, "요척주관 협착증 혹은 추간판 탈출증 환자에서 실시한 경추간공 경막외 스테로이드 주입의 결과에 관한 분석", The Korean Journal of Pain, 21(1), pp.38~43 (2008), 대한통증학회
  7. Manchikanti L, "Percutaneous lysis of epidural adhesions", Pain Physician, 3, pp.46~64 (2000)
  8. Manchikanti L, "Interventional techniques in the management of chronic pain: part 1.0", Pain Physician, 3, pp.7~42 (2000)
  9. Lee JH, "Clinical effectiveness of percutaneous adhesiolysis using Navicath for the management of chronic pain due to lumbosacral disc herniation", Pain Physician, 15, pp.213~221 (2012)
  10. Birkenmaier C, "A biomechanical evaluation of the epidural neurolysis procedure", Pain Physician, 15, pp.E89~E97 (2012)
  11. Manchikanti L, "An update of comprehensive evidence-based guidelines for interventional techniques in chronic spinal pain. Part II: guidance and recommendations", Pain Physician, 16, pp.S49~S283 (2013)
  12. Kim SH, "Effects of transforaminal balloon treatment in patients with lumbar foraminal stenosis: a randomized, controlled, double-blind trial", Pain Physician, 16, pp.213~224 (2013)
  13. Massie JB, "A preclinical post laminectomy rat model mimics the human post laminectomy syndrome", J Neurosci Methods, 137, pp.283~289 (2004)
  14. Haq I, "Postoperative fibrosis after surgical treatment of the porcine spinal cord: a comparison of dural substitutes. Invited submission from the Joint Section Meeting on Disorders of the Spine and Peripheral Nerves, March 2004", J Neurosurg Spine, 2, pp.50~54 (2005)
  15. Heavner JE, "9% NaCl versus 10%NaCl with or without hyaluronidase", Reg Anesth Pain Med, 24, pp.202~207 (1999)
  16. Helm Ii S, "Percutaneous adhesiolysis in the management of chronic low back pain in post lumbar surgery syndrome and spinal stenosis: a systematic review", Pain Physician, 15, pp.E435~E462 (2012)
  17. Helm S, "Spinal endoscopic adhesiolysis in post lumbar surgery syndrome: an update of assessment of the evidence", Pain Physician, 16, pp.SE125~SE150 (2013)
  18. Kim JD, "Epiduroscopic laser disc and neural decompression", J Neurosurg Rev (2012)
  19. 송선옥, "척추수술 후 통증증후군 환자에서 경막외 유착용해술의 임상 경험", Korean Journal of Anesthesiology, 47(4), pp.547~552 (2004), 대한마취통증의학회
  20. 김성훈, "Clinical Experiences of Transforaminal Balloon Decompression for Patients with Spinal Stenosis", The Korean Journal of Pain, 25(1), pp.55~59 (2012), 대한통증학회

관련 논문AI추천

Clinical Experiences of Transforaminal Balloon Decompression for Patients with Spinal Stenosis김성훈, 박평환, 신진우, 임정길, Jeong Hun Suh, Soo Jin Park, Won Uk Koh, Woo Jong Choi대한통증학회 · The Korean Journal of Pain2012 · 제25권 제1호Relationship between Time Elapsed Since Pain Onset and Efficacy of Pain Relief in Patients Undergoing Lumbar Percutaneous Epidural Adhesiolysis김신형, 김희정, 배정빈, 조유빈연세대학교의과대학 · Yonsei Medical Journal2023 · 제64권 제7호Percutaneous Adhesiolysis Versus Transforaminal Epidural Steroid Injection for the Treatment of Chronic Radicular Pain Caused by Lumbar Foraminal Spinal Stenosis: A Retrospective Comparative Study남희승, 박용범, 안재기, 이기훈, 이우영대한재활의학회 · Annals of Rehabilitation Medicine2015 · 제39권 제6호Effectiveness of percutaneous epidural neuroplasty using a balloon catheter in patients with chronic spinal stenosis accompanying mild spondylolisthesis: a longitudinal cohort study감명환, Chan-Sik Kim, Dongreul Lee, Doo-Hwan Kim, Jin-Woo Shin, Seong-Soo Choi, Youngmu Kim대한통증학회 · The Korean Journal of Pain2023 · 제36권 제2호Approach for Epiduroscopic Laser Neural Decompression in Case of the Sacral Canal Stenosis김재중, 양현주, 조대현대한통증학회 · The Korean Journal of Pain2013 · 제26권 제4호Efficacy of Percutaneous Epidural Neuroplasty Does Not Correlate with Dural Sac Cross-Sectional Area in Single Level Disc Disease김긍년, 문봉주, 신동아, 오창현, 윤영설, 지규열, 최승현연세대학교의과대학 · Yonsei Medical Journal2015 · 제56권 제3호

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