title: Efficacy of percutaneous epidural neuroplasty does not correlate with dural sac cross-sectional area in single level disc disease.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  PEN is an effective procedure in treating single level lumbar disc herniation without affecting dural sac cross-sectional area.
authors.affiliation: Department of Neurosurgery, Guro Teun Teun Hospital, Seoul, Korea.; Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Gyu Yeul
authors.initials: GY
authors.lastname: Ji
authors.affiliation: Department of Neurosurgery, Guro Teun Teun Hospital, Seoul, Korea.
authors.forename: Chang Hyun
authors.initials: CH
authors.lastname: Oh
authors.affiliation: Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Bongju
authors.initials: B
authors.lastname: Moon
authors.affiliation: Department of Neurosurgery, Guro Teun Teun Hospital, Seoul, Korea.
authors.forename: Seung Hyun
authors.initials: SH
authors.lastname: Choi
authors.affiliation: Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Korea.; Spine and Spinal Cord Research Institute, Yonsei University College of Medicine, Seoul, Korea. shindongah@me.com.
authors.forename: Dong Ah
authors.initials: DA
authors.lastname: Shin
authors.affiliation: Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Young Sul
authors.initials: YS
authors.lastname: Yoon
authors.affiliation: Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Korea.; Spine and Spinal Cord Research Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Keung Nyun
authors.initials: KN
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D001416:Back Pain / Q000209:etiology / Q000601:surgery*; D004388:Dura Mater / Q000473:pathology*; D005260:Female; D006801:Humans; D007403:Intervertebral Disc; D007405:Intervertebral Disc Displacement; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures; D013130:Spinal Stenosis / Q000150:complications / Q000473:pathology*; D000267:Tissue Adhesions / Q000601:surgery*; D016896:Treatment Outcome; D064232:Visual Analog Scale
keywords: Lower back pain; dural sac cross-sectional area; lumbar disc disease; percutaneous adhesiolysis; percutaneous epidural neuroplasty
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