The Korean Journal of Pain

The Korean Pain Society (대한통증학회)
권호 표지
DOI QR코드

DOI QR Code

Clinical Experiences of Transforaminal Balloon Decompression for Patients with Spinal Stenosis

  • Kim, Sung-Hoon (Department of Anesthesiology and Pain Medicine, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Koh, Won-Uk (Department of Anesthesiology and Pain Medicine, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Park, Soo-Jin (Department of Anesthesiology and Pain Medicine, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Choi, Woo-Jong (Department of Anesthesiology and Pain Medicine, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Suh, Jeong-Hun (Department of Anesthesiology and Pain Medicine, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Leem, Jeong-Gil (Department of Anesthesiology and Pain Medicine, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Park, Pyung-Hwan (Department of Anesthesiology and Pain Medicine, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Shin, Jin-Woo (Department of Anesthesiology and Pain Medicine, University of Ulsan College of Medicine, Asan Medical Center)
  • Received : 2011.09.28
  • Accepted : 2011.11.16
  • Published : 2012.01.01
Download PDF
⟨ Previous Next ⟩

Abstract

Lumbar spinal stenosis is a commonly treated with epidural injections of local anesthetics and corticosteroids, however, these therapies may relieve leg pain for weeks to months but do not influence functional status. Furthermore, the majority of patients report no substantial symptom change over the repeated treatment. Utilizing balloon catheters, we successfully treated with three patients who complained persistent symptoms despite repeated conventional steroid injections. Our results suggest that transforaminal decompression using a balloon catheter may have potential in the nonsurgical treatment of spinal stenosis by modifying the underlying pathophysiology.

Keywords

References

  1. Atlas SJ, Keller RB, Robson D, Deyo RA, Singer DE. Surgical and nonsurgical management of lumbar spinal stenosis: four-year outcomes from the maine lumbar spine study. Spine (Phila Pa 1976) 2000; 25: 556-62.
  2. Benoist M. The natural history of lumbar degenerative spinal stenosis. Joint Bone Spine 2002; 69: 450-7.
  3. Armon C, Argoff CE, Samuels J, Backonja MM; Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. 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 2007; 68: 723-9.
  4. Hwang BM, Hwang BS. A comparison of the efficacy of epidural steroid injections in terms of the dosages and frequency of triancinolone injections for the pain related to lumbar spinal stenosis or herniated disks. Korean J Pain 2006; 19: 72-6.
  5. Hong JH, Lee YC, Lee HM, Kang CH. An analysis of the outcome of transforaminal epidural steroid injections in patients with spinal stenosis or herniated intervertebral discs. Korean J Pain 2008; 21: 38-43.
  6. Katz JN, Harris MB. Clinical practice. Lumbar spinal stenosis. N Engl J Med 2008; 358: 818-25.
  7. Winnie AP, Hartman JT, Meyers HL Jr, Ramamurthy S, Barangan V. Pain clinic. II. Intradural and extradural corticosteroids for sciatica. Anesth Analg 1972; 51: 990-1003.
  8. Coderre TJ. Contribution of protein kinase C to central sensitization and persistent pain following tissue injury. Neurosci Lett 1992; 140: 181-4.
  9. Johansson A, Hao J, Sjolund B. Local corticosteroid application blocks transmission in normal nociceptive C-fibres. Acta Anaesthesiol Scand 1990; 34: 335-8.
  10. Yabuki S, Kikuchi S. Nerve root infiltration and sympathetic block. An experimental study of intraradicular blood flow. Spine (Phila Pa 1976) 1995; 20: 901-6.
  11. Fukusaki M, Kobayashi I, Hara T, Sumikawa K. Symptoms of spinal stenosis do not improve after epidural steroid injection. Clin J Pain 1998; 14: 148-51.
  12. Geurts JW, Kallewaard JW, Richardson J, Groen GJ. Targeted methylprednisolone acetate/hyaluronidase/clonidine injection after diagnostic epiduroscopy for chronic sciatica: a prospective, 1-year follow-up study. Reg Anesth Pain Med 2002; 27: 343-52.
  13. Parke WW, Watanabe R. The intrinsic vasculature of the lumbosacral spinal nerve roots. Spine (Phila Pa 1976) 1985; 10: 508-15.
  14. Kobayashi S, Takeno K, Miyazaki T, Kubota M, Shimada S, Yayama T, et al. Effects of arterial ischemia and venous congestion on the lumbar nerve root in dogs. J Orthop Res 2008; 26: 1533-40.
  15. Lee JS, Kwon HT, Park CH. Anterior epidural irrigation in a lumbar spinal stenosis patient. Korean J Pain 2006; 19: 63-7.
  16. Olmarker K, Rydevik B, Holm S. Edema formation in spinal nerve roots induced by experimental, graded compression. An experimental study on the pig cauda equina with special reference to differences in effects between rapid and slow onset of compression. Spine (Phila Pa 1976) 1989; 14: 569-73.
  17. Basaran A, Topatan S. Spinal balloon nucleoplasty: a hypothetical minimally invasive treatment for herniated nucleus pulposus. Med Hypotheses 2008; 70: 1201-6.
  18. Pedowitz RA, Garfin SR, Massie JB, Hargens AR, Swenson MR, Myers RR, et al. Effects of magnitude and duration of compression on spinal nerve root conduction. Spine (Phila Pa 1976) 1992; 17: 194-9.
  19. Song SO, Lim HJ. Clinical experience of epidural adhesiolysis in patients with failed back surgery syndrome. Korean J Anesthesiol 2004; 47: 547-52.

Cited by

  1. A New Approach to Neuroplasty vol.26, pp.4, 2013, https://doi.org/10.3344/kjp.2013.26.4.323
  2. A Novel Balloon-Inflatable Catheter for Percutaneous Epidural Adhesiolysis and Decompression vol.27, pp.2, 2014, https://doi.org/10.3344/kjp.2014.27.2.178
  3. The Effects of a Forceful Transforaminal Epidural Steroid Injection on Radicular Pain: A Preliminary Study vol.27, pp.4, 2014, https://doi.org/10.3344/kjp.2014.27.4.334
  4. Clinical experiences of performing transforaminal balloon adhesiolysis in patients with failed back surgery syndrome: two cases report vol.66, pp.2, 2014, https://doi.org/10.4097/kjae.2014.66.2.169
  5. Retrodiscal epidural balloon adhesiolysis through Kambinʼs triangle in chronic lumbar spinal stenosis vol.97, pp.41, 2018, https://doi.org/10.1097/MD.0000000000012791
  6. Optimal cut-off points of lumbar pedicle thickness as a morphological parameter to predict lumbar spinal stenosis syndrome: a retrospective study vol.11, pp.None, 2018, https://doi.org/10.2147/jpr.s168990
  7. Usefulness of the Inferior Articular Process’s Cross-Sectional Area as a Morphological Parameter for Predicting Central Lumbar Spinal Stenosis vol.9, pp.1, 2020, https://doi.org/10.3390/jcm9010214