• Jae Hun Kim, Hee Jin Jung, Francis Sahngun Nahm, and Pyung Bok Lee.
• Department of Anesthesiology and Pain Medicine, Konkuk University Medical Center, Seoul, Korea.
• Pain Pract. 2015 Jun 1; 15 (5): 407-13.

ObjectiveThe positive effects of percutaneous epidural neuroplasty (PEN) likely result from elimination of fibrous tissue. However, a direct link between epidural adhesions and pain symptoms is debatable. We tested the hypothesis that epidurographic improvements correspond to improved patient outcome.MethodsIn this prospective study, patients with a filling defect on initial epidurography underwent PEN. Two weeks later, contrast agent distribution around the target area was assessed with repeat epidurography. A successful treatment was defined as over a 50% reduction in visual analog scale (VAS) score 2 weeks postprocedure. The demographic data, history of lumbar spine operation, target nerve, diagnosis, VAS scores, degree of epidurographic improvement, and patient satisfaction were compared between the successful treatment group (Group I) and unsuccessful treatment group (Group II).ResultsSeventy-nine patients were included. Epidurographic findings improved in 67.1% of patients 2 weeks after the procedure. Following PEN, the mean VAS scores of all patients were significantly decreased at 2 weeks (4.12 ± 2.34), 1 month (3.56 ± 2.30), 3 months (3.84 ± 2.45), and 6 months (4.13 ± 2.71) compared with the initial scores (7.82 ± 1.78). In the comparison between Groups I and II, the rate of epidurographic improvement in Group I was higher than in Group II (P = 0.022). Satisfaction in patients that had epidurographic improvement (median satisfaction: 4) was higher than in patients that did not have epidurographic improvement (median satisfaction: 3; P = 0.003).ConclusionThe epidurographic changes following PEN correlate with patient-assessed pain relief and satisfaction.© 2014 World Institute of Pain.

39 keywords...

hide…