Korean J Pain.  2013 Jan;26(1):27-31. 10.3344/kjp.2013.26.1.27.

The Survey of the Patient Received the Epiduroscopic Laser Neural Decompression

• Jo DH
• Yang HJ

• KMID: 1779020
• DOI: http://doi.org/10.3344/kjp.2013.26.1.27

Abstract

BACKGROUND
Neuroplasty using a Racz catheter or epiduroscope and percutaneous endoscopic laser discectomy are performed as treatment for chronic refractory low back and/or lower extremity pain, but they are limited in that they cannot completely remove the causing pathology. Lately, epiduroscopic laser neural decompression (ELND) has been receiving attention as an alternative treatment, but there are insufficient reports of results. Hence we aimed to investigate and report the data in our hospital.
METHODS
Seventy-seven patients were selected who had received ELND via the anterior and posterior epidural approach through the pain clinic in our hospital from March 2011 to July 2012. Their medical records including age, diagnosis, epiduroscopic findings and degree of symptom relief were investigated. The degree of symptom relief following the procedure was categorized into 5 stages of very good (5), good (4), no change (3), bad (2), and very bad (1) at 2 weeks and 1 month after the procedure.
RESULTS
The subjects were 30 males and 47 females. Mean age was 54.6 for males and 59.6 for females, so the overall mean age was 58.1 years old, with the youngest being 23 and the oldest 88 years old. In epiduroscopic images of all patients, more than one situation of herniated disc, fibrous tissue and adhesion, or inflammation was observed. Sixty-seven patients (87.0%) showed symptom relief 2 weeks after the procedure and 63 patients (81.8%) showed relief after 1 month.
CONCLUSIONS
ELND is considered to be an effective treatment alternative for chronic refractory low back and/or lower extremity pain, including lumbar disc herniation, lumbar spinal stenosis, and failed back surgery syndrome which cannot be alleviated with existing non-invasive conservative treatment.

Keyword

anterior epidural approach; epiduroscopic laser neural decompression

MeSH Terms

Catheters
Decompression
Diskectomy
Failed Back Surgery Syndrome
Female
Humans
Inflammation
Intervertebral Disc Displacement
Lower Extremity
Male
Medical Records
Pain Clinics
Spinal Stenosis

Figure

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  Fig. 1 The symptom relief scores according to follow-up period after the procedure.

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  Fig. 2 A 44-year-old man diagnosed of facet joint syndrome at L4-5, L5-S1. (A) T2-weighted MR sagittal image which cannot show epidural fibrosis. (B, C) Epiduroscopic finding of inflammation (B) and thick fibrotic band lesion (C).

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