title: Factors for Predicting Favorable Outcome of Percutaneous Epidural Adhesiolysis for Lumbar Disc Herniation.
abstract: Background. Lower back pain is a common reason for disability and the most common cause is lumbar disc herniation. Percutaneous epidural adhesiolysis has been applied to relieve pain and increase the functional capacity of patients who present this condition.Objectives. In this study, we retrospectively evaluated the factors which predict the outcome of percutaneous epidural adhesiolysis in patients who were diagnosed with lumbar disc herniation.Methods. Electronic medical records of patients diagnosed with lumbar disc herniation who have received percutaneous epidural adhesiolysis treatment were reviewed. The primary outcome was the factors that were associated with substantial response of ≥4 points or ≥50% of pain relief in the numerical rating scale pain score 12 months after the treatment.Results. Multivariate logistic regression analysis demonstrated that the presence of high-intensity zone (HIZ) at magnetic resonance imaging was a predictor of substantial response to percutaneous epidural adhesiolysis for 12 months (P= 0.007). The presence of a condition involving the vertebral foramen was a predictor for unsuccessful response after 12 months (P= 0.02).Discussion and Conclusion. The presence of HIZ was a predictor of favorable long-term outcome after percutaneous epidural adhesiolysis for the treatment of lower back pain with radicular pain caused by lumbar disc herniation.
authors.affiliation: Department of Orthopedic Surgery, Seoul Sacred Heart General Hospital, Wangsan-Ro 259, Dongdaemun-gu, Seoul 02488, Republic of Korea.
authors.forename: Sang Ho
authors.initials: SH
authors.lastname: Moon
authors.affiliation: Department of Orthopedic Surgery, Seoul Sacred Heart General Hospital, Wangsan-Ro 259, Dongdaemun-gu, Seoul 02488, Republic of Korea.
authors.forename: Jae Il
authors.initials: JI
authors.lastname: Lee
authors.affiliation: Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43 gil, Songpa-Gu, Seoul 05505, Republic of Korea.
authors.forename: Hyun Seok
authors.initials: HS
authors.lastname: Cho
authors.affiliation: Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43 gil, Songpa-Gu, Seoul 05505, Republic of Korea.
authors.forename: Jin Woo
authors.initials: JW
authors.lastname: Shin
authors.affiliation: Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43 gil, Songpa-Gu, Seoul 05505, Republic of Korea.
authors.forename: Won Uk
authors.identifier: 0000-0003-4881-1884
authors.initials: WU
authors.lastname: Koh
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005471:Fluoroscopy; D005500:Follow-Up Studies; D006801:Humans; D007268:Injections, Epidural; D007405:Intervertebral Disc Displacement / Q000000981:diagnostic imaging / Q000601:surgery*; D016015:Logistic Models; D008159:Lumbar Vertebrae / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D059408:Pain Management; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D000267:Tissue Adhesions / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome