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Percutaneous epidural adhesiolysis using inflatable balloon catheter and balloon-less catheter in central lumbar spinal stenosis with neurogenic claudication: A randomized controlled trial

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dc.contributor.authorKarm, Myong-Hwan-
dc.contributor.authorChoi, Seong-Soo-
dc.contributor.authorKim, Doo-Hwan-
dc.contributor.authorPark, Jun-Young-
dc.contributor.authorLee, Sukyung-
dc.contributor.authorPark, Jin Kyu-
dc.contributor.authorSuh, Young Joong-
dc.contributor.authorLeem, Jeong-Gil-
dc.contributor.authorShin, Jin Woo-
dc.date.accessioned2024-05-02T06:01:44Z-
dc.date.available2024-05-02T06:01:44Z-
dc.date.created2019-07-10-
dc.date.created2019-07-10-
dc.date.issued2018-11-
dc.identifier.citationPain Physician, Vol.21 No.6, pp.593-605-
dc.identifier.issn1533-3159-
dc.identifier.urihttps://hdl.handle.net/10371/200544-
dc.description.abstractBackground: When conventional interventional procedures fail, percutaneous epidural adhesiolysis (PEA), which has moderate evidence for successful treatment of lumbar spinal stenosis (LSS), has been recommended over surgical treatments. In a previous study, we demonstrated the efficacy of a newly developed inflatable balloon catheter for overcoming the access limitations of pre-existing catheters for patients with severe stenosis or adhesions. Objectives: This study compared the treatment response of combined PEA with balloon decompression and PEA only in patients with central LSS over 6 months of follow-up. Study Design: This study used a randomized, single-blinded, active-controlled trial design. Setting: This study took place in a single-center, academic, outpatient interventional pain management clinic. Methods: This randomized controlled study included 60 patients with refractory central LSS who suffered from chronic lower back pain and/or lumbar radicular pain. Patients failed to maintain improvement for > 1 month with epidural steroid injection or PEA using a balloon-less catheter. Patients were randomly assigned to one of 2 interventions: balloon-less (n = 30) and inflatable balloon catheter (n = 30). The Numeric Rating Scale (NRS-11), Oswestry Disability Index (ODI), Global Perceived Effect of Satisfaction (GPES), and Medication Quantification Scale III were each measured at 1, 3, and 6 months after PEA. Results: There was a significant difference between groups in NRS-11 reduction = 50% (or 4 points), ODI reduction = 30% (or 10 points), GPES = 6 and = 4 points at 6 months, and NRS-11 reduction = 50% (or 4 points) at 3 months after PEA (P < .03). The proportion of successful responders was higher in the balloon group than in the balloon-less group throughout the total follow-up period. Furthermore, there was a statistically significant difference between groups at 6 months after PEA (P = .035). Limitations: The results may vary according to the definition of successful response. Follow-up loss in the present study seemed to be high. Conclusion: PEA using the inflatable balloon catheter leads to significant pain reduction and functional improvement compared to PEA using the balloon-less catheter in patients with central LSS.-
dc.language영어-
dc.publisherAmerican Society of Interventional Pain Physicians-
dc.titlePercutaneous epidural adhesiolysis using inflatable balloon catheter and balloon-less catheter in central lumbar spinal stenosis with neurogenic claudication: A randomized controlled trial-
dc.typeArticle-
dc.citation.journaltitlePain Physician-
dc.identifier.wosid000451640600016-
dc.identifier.scopusid2-s2.0-85060040079-
dc.citation.endpage605-
dc.citation.number6-
dc.citation.startpage593-
dc.citation.volume21-
dc.description.isOpenAccessN-
dc.contributor.affiliatedAuthorKarm, Myong-Hwan-
dc.type.docTypeArticle-
dc.description.journalClass1-
dc.subject.keywordPlusLOW-BACK-PAIN-
dc.subject.keywordPlusLUMBOSACRAL RADICULAR PAIN-
dc.subject.keywordPlusLOWER-EXTREMITY PAIN-
dc.subject.keywordPlusDOUBLE-BLIND-
dc.subject.keywordPlusCLINICAL EFFECTIVENESS-
dc.subject.keywordPlusPULSED RADIOFREQUENCY-
dc.subject.keywordPlusSTEROID INJECTIONS-
dc.subject.keywordPlusSURGERY SYNDROME-
dc.subject.keywordPlusNERVE ROOT-
dc.subject.keywordPlusMANAGEMENT-
dc.subject.keywordAuthorBalloon decompression-
dc.subject.keywordAuthorcentral-
dc.subject.keywordAuthorchronic pain-
dc.subject.keywordAuthorepidural adhesiolysis-
dc.subject.keywordAuthorlumbar-
dc.subject.keywordAuthorpercutaneous-
dc.subject.keywordAuthorradiculopathy-
dc.subject.keywordAuthorspinal stenosis-
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Karm, Myong-Hwan Image

Karm, Myong-Hwan감명환
(기금)조교수
  • School of Dentistry
  • Department of Dentistry
Research Area Dental Anesthesiology, Pain Control, 치과마취, 치과진정법, 통증조절

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