Gil Ho Young, Jeong Sangmin, Cho Hyunwook, Choi Eunjoo, Nahm Francis Sahngun, Lee Pyung-Bok
Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Ajou University College of Medicine, Suwon 16499, Korea.
Department of Anesthesiology and Pain Medicine, Multidisciplinary Pain Center, Seoul National University Bundang Hospital, Seongnam 13496, Korea.
J Clin Med. 2019 Nov 15;8(11):1996. doi: 10.3390/jcm8111996.
Spinal stenosis is a common condition in elderly individuals. Many patients are unresponsive to the conventional treatment. If the transforaminal epidural block does not exert a sufficient treatment effect, percutaneous transforaminal epidural adhesiolysis (PTFA) through the safe-triangle approach using an inflatable balloon catheter can reduce the patients' pain and improve their functional capacity. We aimed to evaluate the safety and efficacy of the Kambin's-triangle approach for PTFA using an inflatable balloon catheter and compare this approach to the traditional safe-triangle approach. Thirty patients with chronic unilateral L5 radiculopathy were divided into two groups: the safe-triangle-approach and Kambin's-triangle-approach groups, with 15 patients each. The success rate of the procedure was assessed. Pain and dysfunction were assessed using the Numerical Rating Scale and Oswestry Disability Index, respectively, before the procedure and at 1 and 3 months after the procedure. The success rate of the procedure was high in both the groups, with no significant difference between the groups. The Numerical Rating Scale and Oswestry Disability Index scores significantly decreased 3 months after the procedure in both the groups, with no significant difference between the groups. For patients in whom the safe-triangle approach for PTFA is difficult, the Kambin's-triangle approach could be an alternative.
腰椎管狭窄症在老年人中较为常见。许多患者对传统治疗无反应。如果经椎间孔硬膜外阻滞治疗效果不佳，使用可膨胀球囊导管经安全三角入路进行经皮椎间孔硬膜外粘连松解术（PTFA）可减轻患者疼痛并改善其功能能力。我们旨在评估使用可膨胀球囊导管经坎宾三角入路进行PTFA的安全性和有效性，并将该方法与传统安全三角入路进行比较。30例慢性单侧L5神经根病患者分为两组：安全三角入路组和坎宾三角入路组，每组15例。评估手术成功率。分别在手术前、术后1个月和3个月使用数字评分量表和Oswestry功能障碍指数评估疼痛和功能障碍情况。两组手术成功率均较高，组间无显著差异。两组患者术后3个月数字评分量表和Oswestry功能障碍指数评分均显著降低，组间无显著差异。对于PTFA采用安全三角入路困难的患者，坎宾三角入路可能是一种替代方法。
