Ji Gyu Yeul, Oh Chang Hyun, Moon Bongju, Choi Seung Hyun, Shin Dong Ah, Yoon Young Sul, Kim Keung Nyun
Department of Neurosurgery, Guro Teun Teun Hospital, Seoul, Korea.; Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Korea.
Department of Neurosurgery, Guro Teun Teun Hospital, Seoul, Korea.
Yonsei Med J. 2015 May;56(3):691-7. doi: 10.3349/ymj.2015.56.3.691.
Percutaneous epidural neuroplasty (PEN) is a minimally invasive treatment. The efficacy of PEN has been relatively well investigated; however, the relationship between the clinical effectiveness of PEN and the severity of spinal canal stenosis by disc material has not yet been established. The purpose of this study was to compare clinical outcomes of PEN according to the dural sac cross-sectional area in single level disc disease.
This study included 363 patients with back pain from single level disc disease with and without radiculopathy. Patients were categorized into groups according to spinal canal compromise by disc material: Category 1, less or more than 50%; and Category 2, three subgroups with lesser than a third, between a third and two thirds, and more than two thirds. Clinical outcomes were assessed according to the Visual Analog Scale (VAS) score for back pain and leg pain and Odom's criteria at 1, 3, 6, 12, and 24 months after treatment.
The demographic data showed no difference between groups according to spinal canal compromise by disc material except age (older age correlated with more spinal canal compromise). The dural sac cross-sectional area did not correlate with the VAS scores for back and leg pain after PEN in single level disc disease in Groups 1 and 2. Odom's criteria after PEN were also not different according to dural sac cross-sectional area by disc material.
PEN is an effective procedure in treating single level lumbar disc herniation without affecting dural sac cross-sectional area.
经皮硬膜外神经成形术（PEN）是一种微创治疗方法。PEN的疗效已得到较为充分的研究；然而，PEN的临床疗效与椎间盘物质导致的椎管狭窄严重程度之间的关系尚未明确。本研究的目的是比较单节段椎间盘疾病中根据硬膜囊横截面积进行PEN治疗后的临床结果。
本研究纳入了363例患有单节段椎间盘疾病伴或不伴神经根病的背痛患者。根据椎间盘物质对椎管的压迫程度将患者分为几组：第1组，压迫小于或大于50%；第2组，分为三个亚组，压迫小于三分之一、介于三分之一和三分之二之间以及大于三分之二。在治疗后1、3、6、12和24个月，根据背痛和腿痛的视觉模拟量表（VAS）评分以及奥多姆标准评估临床结果。
人口统计学数据显示，除年龄外（年龄越大，椎管压迫越严重），根据椎间盘物质对椎管的压迫程度分组的各组之间无差异。在第1组和第2组的单节段椎间盘疾病中，PEN治疗后硬膜囊横截面积与背痛和腿痛的VAS评分无关。根据椎间盘物质导致的硬膜囊横截面积，PEN治疗后的奥多姆标准也无差异。
PEN是治疗单节段腰椎间盘突出症且不影响硬膜囊横截面积的有效方法。
