[논문]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; Chan-Sik Kim; Doo-Hwan Kim; Dongreul Lee; Youngmu Kim; Jin-Woo Shin; Seong-Soo Choi

doi:10.3344/kjp.22289

Effectiveness of percutaneous epidural neuroplasty using a balloon catheter in patients with chronic spinal stenosis accompanying mild spondylolisthesis: a longitudinal cohort study 원문보기

The Korean journal of pain, v.36 no.2, 2023년, pp.184 - 194

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)

Abstract ▼ AI-Helper

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.

주제어

표/그림 (7)

그림 Fig. 1. A flow diagram of the study population. PENB: percutaneous epidural neuroplasty using a balloon catheter.
표 Table 1. Baseline characteristics of the study population
표 Table 2. Intervention characteristics of the study population
표 Table 3. Changes in the estimated pain scores and medication quantification scores after percutaneous epidural neuroplasty using a balloon catheter in patients with chronic spinal stenosis with and without spondylolisthesis
표 Table 4. Adjusted changes in the estimated pain scores and medication quantification scores after percutaneous epidural neuroplasty using a balloon catheter in patients with chronic spinal stenosis with and without spondylolisthesis
표 Table 5. Estimated proportion of improved function after percutaneous epidural neuroplasty using a balloon catheter in patients with chronic spinal stenosis with and without spondylolisthesis
표 Table 6. Additional interventional procedures in the 6-month follow-up period for the study population

참고문헌 (36)

1 Matz PG Meagher RJ Lamer T Tontz WL Jr Annaswamy TM Cassidy RC 2016 Guideline summary review: an evidence-based clinical guideline for the diagnosis and treatment of degenerative lumbar spondylolisthesis Spine J 16 439 48 10.1016/j.spinee.2015.11.055 26681351

상세보기
2 Eismont FJ Norton RP Hirsch BP 2014 Surgical management of lumbar degenerative spondylolisthesis J Am Acad Orthop Surg 22 203 13 10.5435/JAAOS-22-04-203 24668350

상세보기
3 Kalichman L Hunter DJ 2008 Diagnosis and conservative management of degenerative lumbar spondylolisthesis Eur Spine J 17 327 35 10.1007/s00586-007-0543-3 18026865

상세보기
4 Frymoyer JW 1994 Degenerative spondylolisthesis: diagnosis and treatment J Am Acad Orthop Surg 2 9 15 10.5435/00124635-199401000-00002 10708989

상세보기
5 Weinstein JN Lurie JD Tosteson TD Hanscom B Tosteson AN Blood EA 2007 Surgical versus nonsurgical treatment for lumbar degenerative spondylolisthesis N Engl J Med 356 2257 70 10.1056/NEJMoa070302 17538085

상세보기
6 Sencan S Ozcan-Eksi EE Cil H Tay B Berven S Burch S 2017 The effect of transforaminal epidural steroid injections in patients with spondylolisthesis J Back Musculoskelet Rehabil 30 841 6 10.3233/BMR-160543 28372316

상세보기
7 García-Ramos CL Valenzuela-González J Baeza-Álvarez VB Rosales-Olivarez LM Alpízar-Aguirre A Reyes-Sánchez A 2020 Lumbar degenerative spondylolisthesis II: treatment and controversies Acta Ortop Mex 34 433 40 10.35366/99144 34020526

상세보기
8 Lee F Jamison DE Hurley RW Cohen SP 2014 Epidural lysis of adhesions Korean J Pain 27 3 15 10.3344/kjp.2014.27.1.3 24478895

원문보기 상세보기
9 Helm S 2nd Racz GB Gerdesmeyer L Justiz R Hayek SM Kaplan ED 2016 Percutaneous and endoscopic adhesiolysis in managing low back and lower extremity pain: a systematic review and meta-analysis Pain Physician 19 E245 82 10.36076/ppj/2016.19.E245 26815254

상세보기
10 Racz G Candido K Helm S 2018 Neuroplasty is a safe, effective procedure Anesth Analg 126 363 10.1213/ANE.0000000000002546 29135599

상세보기
11 Karm MH Choi SS Kim DH Park JY Lee S Park JK 2018 Percutaneous epidural adhesiolysis using inflatable balloon catheter and balloon-less catheter in central lumbar spinal stenosis with neurogenic claudication: a randomized controlled trial Pain Physician 21 593 606 10.36076/ppj.2018.6.593 30508987
12 Choi SS Joo EY Hwang BS Lee JH Lee G Suh JH 2014 A novel balloon-inflatable catheter for percutaneous epidural adhesiolysis and decompression Korean J Pain 27 178 85 10.3344/kjp.2014.27.2.178 24748948

원문보기 상세보기
13 Choi SS Lee JH Kim D Kim HK Lee S Song KJ 2016 Effectiveness and factors associated with epidural decompression and adhesiolysis using a balloon-inflatable catheter in chronic lumbar spinal stenosis: 1-year follow-up Pain Med 17 476 87 10.1093/pm/pnv018 26814254

상세보기
14 Karm MH Yoon SH Seo DK Lee S Lee Y Cho SS 2019 Combined epidural adhesiolysis and balloon decompression can be effective in intractable lumbar spinal stenosis patients unresponsive to previous epidural adhesiolysis Medicine (Baltimore) 98 e15114 10.1097/MD.0000000000015114 30985668

상세보기
15 Park JY Ji GY Lee SW Park JK Ha D Park Y 2019 Relationship of success rate for balloon adhesiolysis with clinical outcomes in chronic intractable lumbar radicular pain: a multicenter prospective study J Clin Med 8 606 10.3390/jcm8050606 34f2b46e34144c309c8852977b06c70e 31058860

상세보기
16 Moon DE Park HJ Kim YH 2015 Assessment of clinical outcomes of cervical epidural neuroplasty using a Racz-catheter and predictive factors of efficacy in patients with cervical spinal pain Pain Physician 18 E163 70 10.36076/ppj/2015.18.E163 25794215

상세보기
17 Kim DH Cho SS Moon YJ Kwon K Lee K Leem JG 2017 Factors associated with successful responses to transforaminal balloon adhesiolysis for chronic lumbar foraminal stenosis: retrospective study Pain Physician 20 E841 8 10.36076/ppj.20.5.E841 28934790

상세보기
18 Schizas C Theumann N Burn A Tansey R Wardlaw D Smith FW 2010 Qualitative grading of severity of lumbar spinal stenosis based on the morphology of the dural sac on magnetic resonance images Spine (Phila Pa 1976) 35 1919 24 10.1097/BRS.0b013e3181d359bd 20671589

상세보기
19 Lee S Lee JW Yeom JS Kim KJ Kim HJ Chung SK 2010 A practical MRI grading system for lumbar foraminal stenosis AJR Am J Roentgenol 194 1095 8 10.2214/AJR.09.2772 20308517

상세보기
20 Meyerding HW 1933 Diagnosis and roentgenologic evidence in spondylolisthesis Radiology 20 108 20 10.1148/20.2.108
21 Hanson DS Bridwell KH Rhee JM Lenke LG 2002 Correlation of pelvic incidence with low- and high-grade isthmic spondylolisthesis Spine (Phila Pa 1976) 27 2026 9 10.1097/00007632-200209150-00011 12634563

상세보기
22 Gallizzi M Gagnon C Harden RN Stanos S Khan A 2008 Medication Quantification Scale Version III: internal validation of detriment weights using a chronic pain population Pain Pract 8 1 4 10.1111/j.1533-2500.2007.00163.x 18211588

상세보기
23 Kalichman L Kim DH Li L Guermazi A Berkin V Hunter DJ 2009 Spondylolysis and spondylolisthesis: prevalence and association with low back pain in the adult community-based population Spine (Phila Pa 1976) 34 199 205 10.1097/BRS.0b013e31818edcfd 19139672

상세보기
24 Bydon M Alvi MA Goyal A 2019 Degenerative lumbar spondylolisthesis: definition, natural history, conservative management, and surgical treatment Neurosurg Clin N Am 30 299 304 10.1016/j.nec.2019.02.003 31078230

상세보기
25 Faldini C Pagkrati S Acri F Miscione MT Francesconi D Giannini S 2007 Surgical treatment of symptomatic degenerative lumbar spondylolisthesis by decompression and instrumented fusion J Orthop Traumatol 8 128 33 10.1007/s10195-007-0079-7

상세보기
26 Weinstein JN Lurie JD Tosteson TD Zhao W Blood EA Tosteson AN 2009 Surgical compared with nonoperative treatment for lumbar degenerative spondylolisthesis. four-year results in the Spine Patient Outcomes Research Trial (SPORT) randomized and observational cohorts J Bone Joint Surg Am 91 1295 304 10.2106/JBJS.H.00913 19487505

상세보기
27 Fischgrund JS Mackay M Herkowitz HN Brower R Montgomery DM Kurz LT 1997 1997 Volvo Award winner in clinical studies. Degenerative lumbar spondylolisthesis with spinal stenosis: a prospective, randomized study comparing decompressive laminectomy and arthrodesis with and without spinal instrumentation Spine (Phila Pa 1976) 22 2807 12 10.1097/00007632-199712150-00003 9431616

상세보기
28 Fischgrund JS 2004 The argument for instrumented decompressive posterolateral fusion for patients with degenerative spondylolisthesis and spinal stenosis Spine (Phila Pa 1976) 29 173 4 10.1097/01.BRS.0000111142.76601.1A 14722410

상세보기
29 Kaplan NM 1995 Hypertension in the elderly Annu Rev Med 46 27 35 10.1146/annurev.med.46.1.27 7598464

상세보기
30 Freedman MK Hilibrand AS Blood EA Zhao W Albert TJ Vaccaro AR 2011 The impact of diabetes on the outcomes of surgical and nonsurgical treatment of patients in the spine patient outcomes research trial Spine (Phila Pa 1976) 36 290 307 10.1097/BRS.0b013e3181ef9d8c 21270715

상세보기
31 Kim SH Choi WJ Suh JH Jeon SR Hwang CJ Koh WU 2013 Effects of transforaminal balloon treatment in patients with lumbar foraminal stenosis: a randomized, controlled, double-blind trial Pain Physician 16 213 24 10.36076/ppj.2013/16/213 23703408

상세보기
32 Hollmann MW Durieux ME 2000 Prolonged actions of short-acting drugs: local anesthetics and chronic pain Reg Anesth Pain Med 25 337 9 10.1097/00115550-200007000-00001 10925925

상세보기
33 Benzon HT 1986 Epidural steroid injections for low back pain and lumbosacral radiculopathy Pain 24 277 95 10.1016/0304-3959(86)90115-6 3008063

상세보기
34 Hitchcock E 1969 Osmolytic neurolysis for intractable facial pain Lancet 1 434 6 10.1016/S0140-6736(69)91479-2 4179502

상세보기
35 Breivik H Borchgrevink PC Allen SM Rosseland LA Romundstad L Hals EK 2008 Assessment of pain Br J Anaesth 101 17 24 10.1093/bja/aen103 18487245

상세보기
36 Kim DY Lee SH Lee HY Lee HJ Chang SB Chung SK 2005 Validation of the Korean version of the Oswestry disability index Spine (Phila Pa 1976) 30 E123 7 10.1097/01.brs.0000157172.00635.3a 15738775

상세보기

표제어: PCR

동의어: Packet Collision Rate

용어 설명 출처 목록 (6)

용어 설명: PCR은 세균 특이성이 있는 primer를 이용하여 적은 수의 세균이 있을지라도 쉽게 검출할 수 있는 유용한 방법이며, 이를 이용하여 구강 내 치면세균막이나 타액에서 직접 세균을 검출할 수 있게 되었다[8].

내보내기 구분	파일저장 인쇄 메일전송
구성항목	기본정보 상세정보 관리번호, 논문명, 저널/프로시딩명, 저자 , 발행년, 권, 호, 시작페이지, 끝페이지, 발행기관 관리번호, 논문명, 대등논문명, 저자 , 저널/프로시딩명, 발행기관, 발행년, 발행언어, 권, 호, 시작페이지, 끝페이지, ISBN, ISSN, 주제분야, 키워드, 초록(한글), 초록(영문), 저자(소속기관)
저장형식	Text(ASCII format) Excel format RefWorks Direct Export RIS format (for Reference Manager, ProCite, EndNote), Scholar's Aids, Mendeley
메일정보	받는사람 (필수) @ 보내는사람 (선택) @ 제목 내용 KISTI 검색결과 이메일 서비스
안내	총 건의 자료가 검색되었습니다. 다운받으실 자료의 인덱스를 입력하세요. (1-10,000) 검색결과의 순서대로 최대 10,000건 까지 다운로드가 가능합니다. 데이타가 많을 경우 속도가 느려질 수 있습니다.(최대 2~3분 소요) 다운로드 파일은 UTF-8 형태로 저장됩니다. 파일의 내용이 제대로 보이지 않을실 때는 웹브라우저 상단의 보기 -> 인코딩 -> 자동선택 여부를 확인하십시오. ~ Text(ASCII format) Excel format

연합인증