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Efficacy of percutaneous epidural neuroplasty does not correlate with dural sac cross-sectional area in single level disc disease

 Gyu Yeul Ji  ;  Chang Hyun Oh  ;  Bongju Moon  ;  Seung Hyun Choi  ;  Dong Ah Shin  ;  Young Sul Yoon  ;  Keung Nyun Kim 
 YONSEI MEDICAL JOURNAL, Vol.56(3) : 691-697, 2015 
Journal Title
Issue Date
Adult ; Aged ; Back Pain/etiology ; Back Pain/surgery* ; Dura Mater/pathology* ; Female ; Humans ; Intervertebral Disc ; Intervertebral Disc Displacement ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; Spinal Stenosis/complications ; Spinal Stenosis/pathology* ; Tissue Adhesions/surgery* ; Treatment Outcome ; Visual Analog Scale
Lower back pain ; dural sac cross-sectional area ; lumbar disc disease ; percutaneous adhesiolysis ; percutaneous epidural neuroplasty
PURPOSE: Percutaneous epidural neuroplasty (PEN) is a minimally invasive treatment. The efficacy of PEN has been relatively well investigated; however, the relationship between the clinical effectiveness of PEN and the severity of spinal canal stenosis by disc material has not yet been established. The purpose of this study was to compare clinical outcomes of PEN according to the dural sac cross-sectional area in single level disc disease. MATERIALS AND METHODS: This study included 363 patients with back pain from single level disc disease with and without radiculopathy. Patients were categorized into groups according to spinal canal compromise by disc material: Category 1, less or more than 50%; and Category 2, three subgroups with lesser than a third, between a third and two thirds, and more than two thirds. Clinical outcomes were assessed according to the Visual Analog Scale (VAS) score for back pain and leg pain and Odom's criteria at 1, 3, 6, 12, and 24 months after treatment. RESULTS: The demographic data showed no difference between groups according to spinal canal compromise by disc material except age (older age correlated with more spinal canal compromise). The dural sac cross-sectional area did not correlate with the VAS scores for back and leg pain after PEN in single level disc disease in Groups 1 and 2. Odom's criteria after PEN were also not different according to dural sac cross-sectional area by disc material. CONCLUSION: PEN is an effective procedure in treating single level lumbar disc herniation without affecting dural sac cross-sectional area.
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1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Keung Nyun(김긍년)
Shin, Dong Ah(신동아) ORCID logo https://orcid.org/0000-0002-5225-4083
Yoon, Young Sul(윤영설)
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