Factors Predicting the Success of Adhesiolysis Using a Steerable Catheter in Lumbar Failed Back Surgery Syndrome: A Retrospective Study

Abstract

Failed back surgery syndrome (FBSS) is a commonly encountered disease after lumbar surgery. There are many cases where it is difficult to choose a treatment because no specific cause can be found. Nevertheless, according to recent reports, adhesiolysis has shown reasonable evidence. However, considering its poor cost-effectiveness, adhesiolysis cannot be used as the first line of treatment. FBSS patients often suffer from chronic pain; accordingly, they become frustrated when this treatment produces a poor response. Therefore, before the procedure, the target group must be selected carefully. We sought to identify the pre-procedure factors predicting the effect of adhesiolysis in FBSS. A total of 150 patients were evaluated and analyzed retrospectively. Of these 150 patients, 69 were classified as responders three months after the procedure (46%). The outer diameter and grade of foraminal stenosis of the catheter used during the procedure were correlated with the procedure effect. In conclusion, of the 2.1 mm diameter of the catheter, 1.7 mm of it was used during the procedure, and the milder the foraminal stenosis, the greater the pain reduction effect was three months after the procedure.

Predictive Factors Associated with Successful Response to Percutaneous Adhesiolysis in Chronic Lumbar Radicular Pain

“…One of the prominent factors significantly associated with negative treatment outcomes was severe foraminal stenosis on the MRI findings. Similar to our results, several studies evaluating the outcome after PEA have found that severe foraminal stenosis is a predictor of poor prognosis [13,27,28]. Despite the presence of severe foraminal stenosis, 35% of patients included in this study reported successful treatment outcomes.…”

Percutaneous epidural balloon neuroplasty: a narrative review of current evidence

“…Hypotension was also observed at 1.5–1.9%. In patients with post lumbar surgery syndrome, the incidence of dural puncture (8.8%) was more than twice compared with those who have not undergone lumbar surgery [ 23 ]; the incidence was similar to that (8.7%) of conventional PEN in this specific population [ 37 ]. Although three patients underwent temporary weakness in a recent large cohort analysis, all patients completely recovered without neurologic deficits [ 31 ].…”