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患者接受了硬膜外镜激光神经减压术。

The survey of the patient received the epiduroscopic laser neural decompression.

机构信息

Department of Anesthesiology and Pain Medicine, Konyang University Hospital, Daejeon, Korea.

出版信息

Korean J Pain. 2013 Jan;26(1):27-31. doi: 10.3344/kjp.2013.26.1.27. Epub 2013 Jan 4.

Abstract

BACKGROUND

Neuroplasty using a Racz catheter or epiduroscope and percutaneous endoscopic laser discectomy are performed as treatment for chronic refractory low back and/or lower extremity pain, but they are limited in that they cannot completely remove the causing pathology. Lately, epiduroscopic laser neural decompression (ELND) has been receiving attention as an alternative treatment, but there are insufficient reports of results. Hence we aimed to investigate and report the data in our hospital.

METHODS

Seventy-seven patients were selected who had received ELND via the anterior and posterior epidural approach through the pain clinic in our hospital from March 2011 to July 2012. Their medical records including age, diagnosis, epiduroscopic findings and degree of symptom relief were investigated. The degree of symptom relief following the procedure was categorized into 5 stages of very good (5), good (4), no change (3), bad (2), and very bad (1) at 2 weeks and 1 month after the procedure.

RESULTS

The subjects were 30 males and 47 females. Mean age was 54.6 for males and 59.6 for females, so the overall mean age was 58.1 years old, with the youngest being 23 and the oldest 88 years old. In epiduroscopic images of all patients, more than one situation of herniated disc, fibrous tissue and adhesion, or inflammation was observed. Sixty-seven patients (87.0%) showed symptom relief 2 weeks after the procedure and 63 patients (81.8%) showed relief after 1 month.

CONCLUSIONS

ELND is considered to be an effective treatment alternative for chronic refractory low back and/or lower extremity pain, including lumbar disc herniation, lumbar spinal stenosis, and failed back surgery syndrome which cannot be alleviated with existing non-invasive conservative treatment.

摘要

背景

使用 Racz 导管或硬脊膜外镜和经皮内镜激光椎间盘切除术进行神经成形术是治疗慢性难治性腰痛和/或下肢疼痛的方法,但它们存在局限性,无法完全去除致病病理。最近,经硬脊膜外镜激光神经减压术(ELND)作为一种替代治疗方法受到关注,但结果报告不足。因此,我们旨在调查和报告我院的数据。

方法

从 2011 年 3 月至 2012 年 7 月,我们选择了 77 名在我院疼痛诊所接受经前路和后路硬脊膜外腔 ELND 的患者。我们调查了他们的病历,包括年龄、诊断、硬脊膜外镜检查结果和症状缓解程度。在手术后 2 周和 1 个月,根据症状缓解程度将缓解程度分为 5 个等级:非常好(5)、好(4)、无变化(3)、差(2)和非常差(1)。

结果

受试者为 30 名男性和 47 名女性。男性平均年龄为 54.6 岁,女性为 59.6 岁,因此总体平均年龄为 58.1 岁,最小 23 岁,最大 88 岁。在所有患者的硬脊膜外镜图像中,观察到多个椎间盘突出、纤维组织和粘连或炎症情况。67 名患者(87.0%)在手术后 2 周时症状缓解,63 名患者(81.8%)在手术后 1 个月时缓解。

结论

ELND 被认为是治疗慢性难治性腰痛和/或下肢疼痛的有效替代方法,包括腰椎间盘突出症、腰椎管狭窄症和无法通过现有非侵入性保守治疗缓解的失败性腰椎手术综合征。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f3a/3546206/7d4963edd15d/kjpain-26-27-g001.jpg

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