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KMID : 0388720220290040107
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Journal of Korean Society of Spine Surgery
2022 Volume.29 No. 4 p.107 ~ p.114
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Comparison of Clinical Results between Percutaneous Epidural Neuroplasty and Trans-Foraminal Epidural Block for Lumbar Foraminal Stenosis
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Shim Seung-Woo
Kim Min-Young
Kim Young-Jae
Choi Yong-Soo
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Abstract
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Study Design: Retrospective study.
Objectives: To compare the clinical results of percutaneous epidural neuroplasty (PEN) and trans-foraminal epidural block (TFEB).
Summary of Literature Review: Interest has recently emerged in the comparison of PEN and TFEB.
Materials and Methods: Fifty-nine patients who were treated with PEN were classified as group 1 and 70 patients who were treated with TFEB as group 2. In group 1, patients in whom the contrast medium was confined only within the spinal canal were classified as group 1a, and those in whom the contrast medium spread into the root as group 1b. In group 2, patients in whom the contrast medium spread into the spinal canal were classified as group 2a, and those in whom the contrast medium was only confined to the root as group 2b. We analyzed the clinical results.
Results: In both groups, the visual analog scale (VAS), Oswestry disability index, and EQ-5D improved at 6 months of follow-up. The VAS of group 1 had better results at 1 week (p=0.01) and 1 month (p=0.01). Although there were no differences in any results between groups 1a and 1b, group 2b had worse VAS results at 3 days (p=0.01), 1 week (p=0.01), and 1 month (p=0.01) in comparison with group 1.
However, there were no differences in VAS scores between group 2a and group 1 except at 1 week (p=0.03).
Conclusions: PEN showed better improvement of pain earlier than TFEB. However, cases of TFEB in which the contrast medium spread into the spinal canal had almost the same effect of pain improvement as PEN.
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KEYWORD
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Lumbar foraminal stenosis, Percutaneous epidural neuroplasty, Transforaminal epidural block, Clinical results
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