The Survey of the Patient Received the Epiduroscopic Laser Neural Decompression
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Background:Neuroplasty using a Racz catheter or epiduroscope and percutaneous endoscopic laser discectomy are performed as treatment for chronic refractory low back and/or lower extremity pain, but they are limited in that they cannot completely remove the causing pathology. Lately, epiduroscopic laser neural decompression (ELND) has been receiving attention as an alternative treatment, but there are insufficient reports of results. Hence we aimed to investigate and report the data in our hospital. Methods:Seventy-seven patients were selected who had received ELND via the anterior and posterior epidural approach through the pain clinic in our hospital from March 2011 to July 2012. Their medical records including age, diagnosis, epiduroscopic findings and degree of symptom relief were investigated. The degree of symptom relief following the procedure was categorized into 5 stages of very good (5), good (4), no change (3), bad (2), and very bad (1) at 2 weeks and 1 month after the procedure. Results:The subjects were 30 males and 47 females. Mean age was 54.6 for males and 59.6 for females, so the overall mean age was 58.1 years old, with the youngest being 23 and the oldest 88 years old. In epiduroscopic images of all patients, more than one situation of herniated disc, fibrous tissue and adhesion, or inflammation was observed. Sixty-seven patients (87.0%) showed symptom relief 2 weeks after the procedure and 63 patients (81.8%) showed relief after 1 month. Conclusions:ELND is considered to be an effective treatment alternative for chronic refractory low back and/or lower extremity pain, including lumbar disc herniation, lumbar spinal stenosis, and failed back surgery syndrome which cannot be alleviated with existing non-invasive conservative treatment.
Abstract
Background:Neuroplasty using a Racz catheter or epiduroscope and percutaneous endoscopic laser discectomy are performed as treatment for chronic refractory low back and/or lower extremity pain, but they are limited in that they cannot completely remove the causing pathology. Lately, epiduroscopic laser neural decompression (ELND) has been receiving attention as an alternative treatment, but there are insufficient reports of results. Hence we aimed to investigate and report the data in our hospital. Methods:Seventy-seven patients were selected who had received ELND via the anterior and posterior epidural approach through the pain clinic in our hospital from March 2011 to July 2012. Their medical records including age, diagnosis, epiduroscopic findings and degree of symptom relief were investigated. The degree of symptom relief following the procedure was categorized into 5 stages of very good (5), good (4), no change (3), bad (2), and very bad (1) at 2 weeks and 1 month after the procedure. Results:The subjects were 30 males and 47 females. Mean age was 54.6 for males and 59.6 for females, so the overall mean age was 58.1 years old, with the youngest being 23 and the oldest 88 years old. In epiduroscopic images of all patients, more than one situation of herniated disc, fibrous tissue and adhesion, or inflammation was observed. Sixty-seven patients (87.0%) showed symptom relief 2 weeks after the procedure and 63 patients (81.8%) showed relief after 1 month. Conclusions:ELND is considered to be an effective treatment alternative for chronic refractory low back and/or lower extremity pain, including lumbar disc herniation, lumbar spinal stenosis, and failed back surgery syndrome which cannot be alleviated with existing non-invasive conservative treatment.
참고문헌 (12)
- "BMC Anesthesiol", 2005, 10~
- Hayek SM, "Effectiveness of spinal endoscopic adhesiolysis in post lumbar surgery syndrome: a systematic review", Pain Physician, 12, pp.419~435 (2009)
- Manchikanti L, "Spinal endoscopy and lysis of epidural adhesions in the management of chronic low back pain", Pain Physician, 4, pp.240~265 (2001)
- Manchikanti L, "Spinal endoscopic adhesiolysis in the management of chronic low back pain: a preliminary report of a randomized, double-blind trial", Pain Physician, 6, pp.259~267 (2003)
- Richter EO, "Manchiaro PL, et al. Anterior epiduroscopic neural decompression: eight-center experience in 154 patients", Eur J Pain Suppl, 5, pp.401~407 (2011)
- Schenk B, "Experimental basis of percutaneous laser disc decompression (PLDD): a review of literature", Lasers Med Sci, 21, pp.245~249 (2006)
- 이상일, "척추수술 후 통증증후군 환자에서 내시경적 및 비내시경적 경막외 유착용해술에 대한 비교연구", Korean Journal of Anesthesiology, 46(3), pp.329~335 (2004), 대한마취통증의학회
- Ruetten S, "Application of holmium:YAG laser in epiduroscopy: extended practicabilities in the treatment of chronic back pain syndrome", J Clin Laser Med Surg, 20, pp.203~206 (2002)
- Epstein JM, "Laser-assisted percutaneous endoscopic neurolysis", Pain Physician, 3, pp.43~45 (2000)
- Marchetti PG, "Failed back syndromes: opinions and personal experiences", Chir Organi Mov, 79, pp.127~130 (1994)
- Ahn JS, "Laser decompression", J Korean Soc Spine Surg, 7, pp.318~321 (2000)
- 이우용, "요부 척추관 협착증 환자에서 경막외내시경의 효과", The Korean Journal of Pain, 15(2), pp.154~158 (2002), 대한통증학회
