The Korean Journal of Pain

The Korean Pain Society (대한통증학회)
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Effectiveness of percutaneous epidural neuroplasty using a balloon catheter in patients with chronic spinal stenosis accompanying mild spondylolisthesis: a longitudinal cohort study

  • Myong-Hwan Karm (Department of Dental Anesthesiology, School of Dentistry and Dental Research Institute, Seoul National University) ;
  • Chan-Sik Kim (Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Doo-Hwan Kim (Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Dongreul Lee (Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Youngmu Kim (Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Jin-Woo Shin (Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Seong-Soo Choi (Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine)
  • Received : 2022.08.17
  • Accepted : 2022.10.13
  • Published : 2023.04.01
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Abstract

Background: Degenerative lumbar spondylolisthesis (DLS) is frequently associated with lumbar spinal stenosis (LSS) and conservative treatments such as epidural steroid injection do not have long-term benefits in LSS patients with DLS. This study evaluated the effectiveness of percutaneous epidural neuroplasty using a balloon catheter in patients with LSS and DLS. Methods: Patients' sex, age, body mass index, diabetes, hypertension, stenosis grading, pain duration, location, pain intensity, and medications were retrieved from electronic medical records. At 1, 3, and 6 months following the procedure, data on pain severity, medication usage, and physical functional status were analyzed. A generalized estimating equations model was used at the six-month follow-up. Patients were divided into those with DLS (the spondylolisthesis group) and those without DLS (the no spondylolisthesis group) to evaluate whether the effects of percutaneous epidural neuroplasty using a balloon catheter were different. Results: A total of 826 patients were included (spondylolisthesis: 433 patients, 52.4%; no spondylolisthesis: 393 patients, 47.6%). Age, body mass index, hypertension, pain location, and stenosis grading were statistically different between the two groups. The generalized estimating equations analyses with unadjusted and adjusted estimation 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). Any adverse events that occurred were minor and temporary. Conclusions: Percutaneous epidural neuroplasty using a balloon catheter may be an alternative treatment option for patients with chronic LSS, regardless of accompanying DLS, who have had failed conservative management.

Keywords

Acknowledgement

The authors appreciate Dr. Seong-Sik Cho, MD, MPH, PhD (the Department of Occupational and Environmental Medicine, College of Medicine, Dong-A University, Busan, Korea) for the statistical support. The authors would like to thank residents in the Department of Anesthesiology and Pain Medicine, the Asan Medical Center for assistance of data collection in this study. The authors would like to thank Dental Research Institute of Seoul National University for the English language review.

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