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      • Record: found
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      Clinical Experiences of Transforaminal Balloon Decompression for Patients with Spinal Stenosis

      case-report

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          Abstract

          Lumbar spinal stenosis is a commonly treated with epidural injections of local anesthetics and corticosteroids, however, these therapies may relieve leg pain for weeks to months but do not influence functional status. Furthermore, the majority of patients report no substantial symptom change over the repeated treatment. Utilizing balloon catheters, we successfully treated with three patients who complained persistent symptoms despite repeated conventional steroid injections. Our results suggest that transforaminal decompression using a balloon catheter may have potential in the nonsurgical treatment of spinal stenosis by modifying the underlying pathophysiology.

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          Clinical practice. Lumbar spinal stenosis.

          Jeffrey Katz, Richard Harris (2008)
          Article 0 comments Cited 127 times – based on 0 reviews     Review now
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            Local corticosteroid application blocks transmission in normal nociceptive C-fibres.

            A. Johansson, J Hao, B Sjölund (1990)
            The effect of a locally applied depot form of a corticosteroid on the electrical properties of nerves was investigated in an experimental model. The segmental transmission in electrically stimulated A-fibres and in C-fibres of the plantar nerve in the anaesthetized rat was utilized. A drop of methylprednisolone acetate or vehicle constituent was placed on the dissected plantar nerve proximal to the stimulating electrodes after recording control responses (A-fibre volley in the sciatic nerve and C-fibre evoked reflex discharge in flexor motoneurons). The corticosteroid was found to suppress the transmission in thin unmyelinated C-fibres but not in myelinated A-beta fibres. The effect was found to be due to the corticosteroid per se. The effect was reversed when the corticosteroid was removed, which suggests a direct membrane action.
            Article 0 comments Cited 96 times – based on 0 reviews     Review now
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              Symptoms of spinal stenosis do not improve after epidural steroid injection.

              M Fukusaki, Natsuko I. Kobayashi, K Sumikawa … (1998)
              This study was carried out to evaluate the therapeutic effect of epidural steroid injection on pseudoclaudication in patients with lumbar degenerative spinal canal stenosis. Fifty-three patients who complained of pseudoclaudication of less than 20 m in walking distance were randomly divided into three groups. Group 1 (n = 16) underwent epidural injection with 8 ml of saline. Group 2 (n = 18) underwent epidural block with 8 ml of 1% mepivacaine. Group 3 (n = 19) underwent epidural block with a combination of 8 ml of 1% mepivacaine and 40 mg of methylprednisolone. The criteria of evaluation were as follows: excellent effect, > 100 m in walking distance; good effect, 20-100 m in walking distance; poor effect, <20 m in walking distance. In group 1, the numbers of patients who showed a good effect were two (12.5%) after 1 week, one (6.5%) after 1 month, and one (6.5%) after 3 months. In group 2, the numbers of patients who showed a good or excellent result were 10 (55.5%) after 1 week, three (16.7%) after 1 month, and one (5.6%) after 3 months. In group 3, the numbers of patients who showed a good or excellent result were 12 (63.2%) after 1 week, three (15.8%) after 1 month, and one (5.3%) after 3 months. There was no significant difference in the effectiveness of treatment between group 2 and group 3 throughout the time course. The results suggest that epidural steroid injection has no beneficial effect on the pseudoclaudication associated with spinal canal stenosis as compared with epidural block with a local anesthetic alone.
              Article 0 comments Cited 43 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Korean J Pain
                Journal ID (publisher-id): KJP
                Title: The Korean Journal of Pain
                Publisher: The Korean Pain Society
                ISSN (Print): 2005-9159
                ISSN (Electronic): 2093-0569
                Publication date (Print): January 2012
                Publication date (Electronic): 02 January 2012
                Volume: 25
                Issue: 1
                Pages: 55-59
                Affiliations
                Department of Anesthesiology and Pain Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
                Author notes
                Correspondence to: Jin Woo Shin, MD. Department of Anesthesiology and Pain Medicine, University of Ulsan College of Medicine, Asan Medical Center, 86, Asanbyeongwon-gil, Songpa-gu, Seoul 138-736, Korea. Tel: +82-2-3010-3868, Fax: +82-2-3010-6790, jinwoos@ 123456amc.seoul.kr
                Article
                DOI: 10.3344/kjp.2012.25.1.55
                PMC ID: 3259140
                PubMed ID: 22259719
                SO-VID: 06742841-8faa-4b4e-882c-9b9a6bf45731
                Copyright © Copyright © The Korean Pain Society, 2012
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 28 September 2011
                Date revision received : 11 November 2011
                Date accepted : 16 November 2011
                Categories
                Subject: Case Report

                ScienceOpen disciplines: Anesthesiology & Pain management
                Keywords: decompressive neuroplasty,epidural injection,spinal stenosis
                Data availability:
                ScienceOpen disciplines: Anesthesiology & Pain management
                Keywords: decompressive neuroplasty, epidural injection, spinal stenosis

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