Background & Aims

Chronic low back pain can be caused by various factors; herniated lumbar disc disease, lumbar spinal stenosis, facet joint disease, etc. Non-surgical treatments of chronic low back pain include interventional procedures, such as lumbar epidural injection and facet joint nerve block in addition to physiotherapy and analgesic medication. In addition, percutaneous epidural adhesiolysis (PEA) can be performed when the conventional intervention was ineffective in pain reducing or duration time. PEA is an effective intervention to remove epidural scarring by placing a catheter directly into the fibrous adhesions and chemical adhesiolysis. PEA of caudal epidural approach is done with various types of catheters. This study aims to compare the effects of three catheter types: Racz, balloon-inflatable, and radiofrequency catheter.

Methods

This study was a retrospective study including total 35 patients with LBP who underwent PEA and evaluated both VAS and ODI score. (Radiofrequency catheter group: 11 patients, balloon –inflatable catheter group: 12 patients, and Racz catheter group: 11 patients). The outcome measure was the Visual Analogue Scale (VAS) scores and Oswestry Disability Index (ODI). These measures were assessed at two time points: E1, pretreatment and E2, posttreatment.

Results

Demographic data and baseline characteristics associated with each group showed no significant differences in baseline demographic among groups (Table 1). In the intragroup comparison, Radiofrequency and balloon-inflatable catheter groups showed significant improvements in the VAS after treatment. Also, Radiofrequency catheter group showed the largest changes in VAS among three groups. The ODI scores showed significant intragroup differences after treatment in balloon-inflatable and Racz catheter group. However, there were no significant differences intergroup differences in any of outcomes (Table 2).

Conclusions

This study compared the effects of three catheter types: Racz catheter, balloon-inflatable and high-frequency catheters. All three groups showed significant improvement in pain and functional evaluation before and after the procedure. There was no significant difference in comparison between groups.

References

1. Choi, Seong-Soo, et al. “Effectiveness and factors associated with epidural decompression and adhesiolysis using a balloon-inflatable catheter in chronic lumbar spinal stenosis: 1-year follow-up.” Pain medicine 17.3 (2016): 476-487.
2. Kim, Doo Hwan, et al. “Factors associated with successful responses to transforaminal balloon adhesiolysis for chronic lumbar foraminal stenosis: retrospective study.” Pain Physician 20.6 (2017): E841.
3. Manchikanti, Laxmaiah, et al. “An update of comprehensive evidence-based guidelines for interventional techniques in chronic spinal pain. Part I: introduction and general considerations.” Pain Physician 16.2S (2013): S1.
4. Manchikanti, Laxmaiah, et al. “An update of comprehensive evidence-based guidelines for interventional techniques in chronic spinal pain. Part II: guidance and recommendations.” Pain physician 16.2S (2013): S49.
5. Oh, Chang Hyun, et al. “The catheter tip position and effects of percutaneous epidural neuroplasty in patients with lumbar disc disease during 6-months of follow-up.” (2014): 599-607.
6. Se Hee Kim and Sang Sik Choi. “Epidural neuroplasty/epidural adhesiolysis.” Anesthesia and Pain Medicine 11.1 (2016): 14-22.

Presenting Author

Sung-Woon Baik

Poster Authors

Gi-Wook Kim

MD, Ph.D

Jeonbuk National University Medical School

Lead Author

E-mail

Sung Woon Baik

Jeonbuk National University Medical School

Lead Author

E-mail

Seong Yeol Kim

Jeonbuk National University Hospital

Lead Author

E-mail

Da-Sol Kim (MD

Ph.D)

Jeonbuk National University Medical School

Lead Author

E-mail

Yu Hui Won (MD

Ph.D)

Jeonbuk National University Medical School

Lead Author

E-mail

Sung-Hee Park (MD

Ph.D)

Jeonbuk National University Medical School

Lead Author

E-mail

Myoung-Hwan Ko (MD

Ph.D)

Jeonbuk National University Medical School

Lead Author

E-mail

Jeong-Hwan Seo (MD

Ph.D)

Jeonbuk National University Medical School

Lead Author

E-mail

Topics

  • Treatment/Management: Interventional Therapies – Injections/Blocks

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