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논문 기본 정보

자료유형
학술저널
저자정보
Cho, Pyung Goo (Department of Neurosurgery, Ajou University College of Medicine) Ji, Gyu Yeul (Department of Neurosurgery, Cham Teun Teun Research Institute) Yoon, Young Sul (Department of Neurosurgery, Yonsei University College of Medicine) Shin, Dong Ah (Department of Neurosurgery, Yonsei University College of Medicine)
저널정보
대한신경외과학회 대한신경외과학회지 대한신경외과학회지 제62권 제6호
발행연도
2019.1
수록면
681 - 690 (10page)

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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.
#Low back pain #Herniated disc #Percutaneous epidural neuroplasty #Percutaneous adhesiolysis #Treatment outcome

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참고문헌 (31)

참고문헌 신청
Canale ST BJ / 2003 / Campbell’s operative orthopaedics / Elsevier google schola Carey TS / 2000 / Beyond the good prognosis. Examination of an inception cohort of patients with chronic low back pain / Spine (Phila Pa 1976) 25:115~120 google schola Carragee EJ / 2003 / Clinical outcomes after lumbar discectomy for sciatica: the effects of fragment type and anular competence / J Bone Joint Surg Am 85:102~108 google schola Chopra P / 2005 / Role of adhesiolysis in the management of chronic spinal pain: a systematic review of effectiveness and complications / Pain Physician 8:87~100 google schola Epter RS / 2009 / Systematic review of percutaneous adhesiolysis and management of chronic low back pain in post lumbar surgery syndrome / Pain Physician 12:361~378 google schola

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