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Clinical Effectiveness of Percutaneous Epidural Neuroplasty According to the Type of Single-Level Lumbar Disc Herniation : A 12-Month Follow-Up Study

Authors
 Pyung Goo Cho  ;  Gyu Yeul Ji  ;  Young Sul Yoon  ;  Dong Ah Shin 
Citation
 JOURNAL OF KOREAN NEUROSURGICAL SOCIETY, Vol.62(6) : 681-690, 2019-11 
Journal Title
 JOURNAL OF KOREAN NEUROSURGICAL SOCIETY 
ISSN
 2005-3711 
Issue Date
2019-11
Keywords
Low back pain ; Herniated disc ; Percutaneous epidural neuroplasty ; Percutaneous adhesiolysis ; Treatment outcome
Abstract
Objective: To determine whether the outcomes of percutaneous epidural neuroplasty (PEN) are influenced by the type of lumbar disc herniation (LDH) and evaluate the effectiveness of PEN in patients with single-level LDH. Methods: This study included 430 consecutive patients with single-level LDH who underwent PEN. Before treatment, the LDH type was categorized as bulging, protrusion, extrusion, and sequestration, while Pfirrmann grades were assigned according to imaging findings. Visual analog scale (VAS) scores for back and leg pain and success rates (Odom's criteria) were assessed at 1, 3, 6, and 12 months after treatment. Results: The mean preoperative VAS scores for back and leg pain were 6.90 and 4.23, respectively; these decreased after PEN as follows : 2.25 and 1.45, respectively, at 1 month; 2.61 and 1.68, respectively, at 3 months; 2.28 and 1.48, respectively, at 6 months; and 2.88 and 1.48, respectively, at 12 months (p<0.001). The decrease in VAS scores for leg pain was significantly greater in the extrusion and sequestration groups than in the other two groups (p<0.05); there were no other significant differences among groups. More than 70% patients exhibited good or excellent 12-month outcomes according to Odom's criteria. Subsequent surgery was required for 59 patients (13.7%), with a significantly higher rate in the extrusion (25.0%) and sequestration (30.0%) groups than in the bulging (7.3%) and protrusion (13.8%) groups (p<0.05). Nevertheless, subsequent surgery was not required for >70% patients with extrusion or sequestration. Patients with Pfirrmann grades 1-3 (14.0-21.5%) showed a significantly higher rate of subsequent surgery than those with Pfirrmann grade 0 (4.9%; p<0.05). Conclusion: Our findings suggest that PEN is an effective treatment for back and leg pain caused by single-level LDH, with the outcomes remaining unaffected by the LDH type.
Files in This Item:
T201906312.pdf Download
DOI
10.3340/jkns.2019.0070
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Shin, Dong Ah(신동아) ORCID logo https://orcid.org/0000-0002-5225-4083
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/175851
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