Korean J Pain.  2013 Oct;26(4):392-395. 10.3344/kjp.2013.26.4.392.

Approach for Epiduroscopic Laser Neural Decompression in Case of the Sacral Canal Stenosis

• Jo DH
• Yang HJ
• Kim JJ

• KMID: 2074049
• DOI: http://doi.org/10.3344/kjp.2013.26.4.392

Abstract

Epiduroscopy is very useful in the treatment of not only low back pain caused by failed back surgery syndrome, epidural scar or herniated disc but also by chronic refractory low back pain which does not respond to interventional conservative treatment including fluoroscopically-directed epidural steroid injections and percutaneous adhesiolysis. Because cauterization using a laser fiber has become recently available, a wider opening is required to enter into the sacral canal in the case of epiduroscopic laser neural decompression (ELND). However, in a few patients, it is difficult to insert a device into the epidural space due to stenosis around the opening, and there is no alternative method. Herein, we report a case where a hiatus rasp specially designed for such patients was used to perform the operation.

Keyword

epiduroscopic laser neural decompression; hiatus rasp; sacral canal; stenosis

MeSH Terms

Cicatrix
Constriction, Pathologic
Decompression
Epidural Space
Failed Back Surgery Syndrome
Humans
Intervertebral Disc Displacement
Low Back Pain

Figure

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  Fig. 1 A lumbosacral MRI sagittal plane image showing a narrow sacral canal.

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  Fig. 2 The hiatus rasp.

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  Fig. 3 A C-arm image in which a S4 laminotomy is performed using the rasp.

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