Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Korean J Pain. 2014 Apr;27(2):178-85. doi: 10.3344/kjp.2014.27.2.178. Epub 2014 Mar 28.
Epidural adhesions cause pain by interfering with the free movement of the spinal nerves and increasing neural sensitivity as a consequence of neural compression. To remove adhesions and deliver injected drugs to target sites, percutaneous epidural adhesiolysis (PEA) is performed in patients who are unresponsive to conservative treatments. We describe four patients who were treated with a newly developed inflatable balloon catheter for more effective PEA and relief of stenosis. In the present patients, treatments with repetitive epidural steroid injection and/or PEA with the Racz catheter or the NaviCath did not yield long-lasting effects or functional improvements. However, PEA and decompression with the inflatable balloon catheter led to maintenance of pain relief for more than seven months and improvements in the functional status with increases in the walking distance. The present case series suggests that the inflatable balloon catheter may be an effective alternative to performing PEA when conventional methods fail to remove adhesions or sufficiently relieve stenosis.
硬膜外粘连通过干扰脊神经的自由运动，并由于神经受压而增加神经敏感性，从而引起疼痛。对于那些对保守治疗无反应的患者，可通过经皮硬膜外粘连松解术（PEA）来去除粘连并将注射药物递送至目标部位。我们描述了 4 例使用新开发的可充气球囊导管进行更有效的 PEA 和缓解狭窄的患者。在本患者中，重复硬膜外类固醇注射和/或使用 Racz 导管或 NaviCath 进行 PEA 的治疗并未产生持久的效果或功能改善。然而，使用可充气球囊导管进行 PEA 和减压导致疼痛缓解持续了七个多月，并改善了功能状态，增加了步行距离。本病例系列表明，当常规方法无法去除粘连或充分缓解狭窄时，可充气球囊导管可能是进行 PEA 的有效替代方法。
