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Transforaminal Epidural Balloon Adhesiolysis via a Contralateral Interlaminar Retrograde Foraminal Approach: A Retrospective Analysis and Technical Considerations

Several treatment modalities have been proposed for foraminal stenosis, but the treatment options remain unsatisfactory. Previous studies have shown that transforaminal balloon adhesiolysis may be effective in patients with refractory lumbar foraminal stenosis. However, in patients with a high iliac...

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Autores principales: Kim, Chan-Sik, Moon, Yeon-Jin, Kim, Jae Won, Hyun, Dong-Min, Son, Shill Lee, Shin, Jin-Woo, Kim, Doo-Hwan, Choi, Seong-Soo, Karm, Myong-Hwan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7230206/
https://www.ncbi.nlm.nih.gov/pubmed/32244742
http://dx.doi.org/10.3390/jcm9040981
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author Kim, Chan-Sik
Moon, Yeon-Jin
Kim, Jae Won
Hyun, Dong-Min
Son, Shill Lee
Shin, Jin-Woo
Kim, Doo-Hwan
Choi, Seong-Soo
Karm, Myong-Hwan
author_facet Kim, Chan-Sik
Moon, Yeon-Jin
Kim, Jae Won
Hyun, Dong-Min
Son, Shill Lee
Shin, Jin-Woo
Kim, Doo-Hwan
Choi, Seong-Soo
Karm, Myong-Hwan
author_sort Kim, Chan-Sik
collection PubMed
description Several treatment modalities have been proposed for foraminal stenosis, but the treatment options remain unsatisfactory. Previous studies have shown that transforaminal balloon adhesiolysis may be effective in patients with refractory lumbar foraminal stenosis. However, in patients with a high iliac crest, balloon catheter insertion may be difficult via a conventional transforaminal approach (particularly targeting the L5–S1 foramen). It has been reported that an epidural catheter can be placed easily by a contralateral interlaminar retrograde foraminal approach. Therefore, we applied this approach to L5–S1 transforaminal balloon adhesiolysis in patients with a high iliac crest. We retrospectively analyzed data from 22 patients who underwent combined epidural adhesiolysis and balloon decompression (balloon adhesiolysis) using the novel foraminal balloon catheter via a contralateral interlaminar retrograde foraminal approach. The pain intensity significantly decreased over the three-month period after balloon adhesiolysis (p < 0.001). There were no complications associated with the balloon procedure. The present study suggests that balloon adhesiolysis for L5-S1 foramen via a contralateral interlaminar retrograde foraminal approach may be an effective alternative for patients with a high iliac crest and refractory lumbar radicular pain due to lumbar foraminal stenosis. In addition, detailed procedural aspects are described here.
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spelling pubmed-72302062020-05-28 Transforaminal Epidural Balloon Adhesiolysis via a Contralateral Interlaminar Retrograde Foraminal Approach: A Retrospective Analysis and Technical Considerations Kim, Chan-Sik Moon, Yeon-Jin Kim, Jae Won Hyun, Dong-Min Son, Shill Lee Shin, Jin-Woo Kim, Doo-Hwan Choi, Seong-Soo Karm, Myong-Hwan J Clin Med Article Several treatment modalities have been proposed for foraminal stenosis, but the treatment options remain unsatisfactory. Previous studies have shown that transforaminal balloon adhesiolysis may be effective in patients with refractory lumbar foraminal stenosis. However, in patients with a high iliac crest, balloon catheter insertion may be difficult via a conventional transforaminal approach (particularly targeting the L5–S1 foramen). It has been reported that an epidural catheter can be placed easily by a contralateral interlaminar retrograde foraminal approach. Therefore, we applied this approach to L5–S1 transforaminal balloon adhesiolysis in patients with a high iliac crest. We retrospectively analyzed data from 22 patients who underwent combined epidural adhesiolysis and balloon decompression (balloon adhesiolysis) using the novel foraminal balloon catheter via a contralateral interlaminar retrograde foraminal approach. The pain intensity significantly decreased over the three-month period after balloon adhesiolysis (p < 0.001). There were no complications associated with the balloon procedure. The present study suggests that balloon adhesiolysis for L5-S1 foramen via a contralateral interlaminar retrograde foraminal approach may be an effective alternative for patients with a high iliac crest and refractory lumbar radicular pain due to lumbar foraminal stenosis. In addition, detailed procedural aspects are described here. MDPI 2020-04-01 /pmc/articles/PMC7230206/ /pubmed/32244742 http://dx.doi.org/10.3390/jcm9040981 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Kim, Chan-Sik
Moon, Yeon-Jin
Kim, Jae Won
Hyun, Dong-Min
Son, Shill Lee
Shin, Jin-Woo
Kim, Doo-Hwan
Choi, Seong-Soo
Karm, Myong-Hwan
Transforaminal Epidural Balloon Adhesiolysis via a Contralateral Interlaminar Retrograde Foraminal Approach: A Retrospective Analysis and Technical Considerations
title Transforaminal Epidural Balloon Adhesiolysis via a Contralateral Interlaminar Retrograde Foraminal Approach: A Retrospective Analysis and Technical Considerations
title_full Transforaminal Epidural Balloon Adhesiolysis via a Contralateral Interlaminar Retrograde Foraminal Approach: A Retrospective Analysis and Technical Considerations
title_fullStr Transforaminal Epidural Balloon Adhesiolysis via a Contralateral Interlaminar Retrograde Foraminal Approach: A Retrospective Analysis and Technical Considerations
title_full_unstemmed Transforaminal Epidural Balloon Adhesiolysis via a Contralateral Interlaminar Retrograde Foraminal Approach: A Retrospective Analysis and Technical Considerations
title_short Transforaminal Epidural Balloon Adhesiolysis via a Contralateral Interlaminar Retrograde Foraminal Approach: A Retrospective Analysis and Technical Considerations
title_sort transforaminal epidural balloon adhesiolysis via a contralateral interlaminar retrograde foraminal approach: a retrospective analysis and technical considerations
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7230206/
https://www.ncbi.nlm.nih.gov/pubmed/32244742
http://dx.doi.org/10.3390/jcm9040981
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