• Title/Summary/Keyword: decompressive neuroplasty

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Effectiveness of continuous hypertonic saline infusion with an automated infusion pump for decompressive neuroplasty: a randomized clinical trial

  • Lee, Ho-Jin;Lee, Jaewoo;Park, Yeon wook;Gil, Ho Young;Choi, Eunjoo;Nahm, Francis Sahngun;Lee, Pyung Bok
    • The Korean Journal of Pain
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    • v.32 no.3
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    • pp.196-205
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    • 2019
  • Background: Hypertonic saline (HS) injections for decompressive neuroplasty (DN) can cause pain. We assessed whether a continuous infusion of HS through an infusion pump would reduce injection-related pain compared with repeated bolus administrations. Methods: Fifty patients scheduled for DN were randomized to either the bolus injection or the continuous infusion group. After appropriately placing the epidural catheter, 4 mL of 5% NaCl was injected as four boluses of 1 mL each at 15-minute intervals or infused over 1 hour using an infusion pump. The severity of pain induced by HS injection, as measured by the 11-point numerical rating scale (NRS), was the primary outcome. The severity of low back or lower extremity pain, as measured by the 11-point NRS and Oswestry Disability Index (ODI), 3 months following the procedure, was the secondary outcome. Results: Data from 21 patients in the bolus group and 23 in the continuous infusion group were analyzed. No statistically significant difference in injection-related pain was identified between the two groups during the initial HS administration (P = 0.846). However, there was a statistically significant reduction in injection-related pain in the continuous infusion group compared to the bolus injection group from the second assessment onwards (P = 0.001, < 0.001, and < 0.001, respectively). No significant between-group differences in the NRS and ODI scores 3 months post-procedure were noted (P = 0.614 and 0.949, respectively). Conclusions: Our study suggests that administering HS through a continuous infusion is a useful modality for reducing HS injection-related pain during DN.

Clinical Experiences of Transforaminal Balloon Decompression for Patients with Spinal Stenosis

  • Kim, Sung-Hoon;Koh, Won-Uk;Park, Soo-Jin;Choi, Woo-Jong;Suh, Jeong-Hun;Leem, Jeong-Gil;Park, Pyung-Hwan;Shin, Jin-Woo
    • The Korean Journal of Pain
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    • v.25 no.1
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    • pp.55-59
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    • 2012
  • 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.