Korean J Pain.  2023 Apr;36(2):184-194. 10.3344/kjp.22289.

Effectiveness of percutaneous epidural neuroplasty using a balloon catheter in patients with chronic spinal stenosis accompanying mild spondylolisthesis: a longitudinal cohort study

• Karm MH
• Kim CS
• Kim DH
• Lee D
• Kim Y
• Shin JW
• Choi SS

• KMID: 2541027
• DOI: http://doi.org/10.3344/kjp.22289

Abstract

Background
Degenerative lumbar spondylolisthesis (DLS) is frequently associated with lumbar spinal stenosis (LSS) and conservative treatments such as epidural steroid injection do not have long-term benefits in LSS patients with DLS. This study evaluated the effectiveness of percutaneous epidural neuroplasty using a balloon catheter in patients with LSS and DLS.
Methods
Patients’ sex, age, body mass index, diabetes, hypertension, stenosis grading, pain duration, location, pain intensity, and medications were retrieved from electronic medical records. At 1, 3, and 6 months following the procedure, data on pain severity, medication usage, and physical functional status were analyzed. A generalized estimating equations model was used at the six-month follow-up. Patients were divided into those with DLS (the spondylolisthesis group) and those without DLS (the no spondylolisthesis group) to evaluate whether the effects of percutaneous epidural neuroplasty using a balloon catheter were different.
Results
A total of 826 patients were included (spondylolisthesis: 433 patients, 52.4%; no spondylolisthesis: 393 patients, 47.6%). Age, body mass index, hypertension, pain location, and stenosis grading were statistically different between the two groups. The generalized estimating equations analyses with unadjusted and adjusted estimation revealed a significant improvement in the estimated mean numerical rating scale of pain intensities compared to that at baseline in both groups (P < 0.001). Any adverse events that occurred were minor and temporary.
Conclusions
Percutaneous epidural neuroplasty using a balloon catheter may be an alternative treatment option for patients with chronic LSS, regardless of accompanying DLS, who have had failed conservative management.

Keyword

Chronic Pain; Injections, Epidural; Low Back Pain; Lumbar Vertebrae; Neuroplasty; Pain Management; Spinal Stenosis; Spondylolisthesis

Figure

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  Fig. 1 A flow diagram of the study population. PENB: percutaneous epidural neuroplasty using a balloon catheter.

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