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

Abstract

Percutaneous adhesiolysis (PEA) is of interest in the treatment of lumbar radicular pain. This study aimed to assess the effectiveness of PEA in patients with chronic lumbar radicular pain refractory to epidural steroid injections and to determine predictive factors, including demographic, clinical, and procedural data, to provide superior treatment efficacy. One hundred and ninety-three patients were reviewed. Successful treatment outcome was described as a 50% reduction in the visual analog scale score. Among the 193 patients, 109 (56.2%) exhibited a positive treatment response at 12 months. In multivariate logistic regression analysis, no depression (OR, 3.105; 95% CI, 1.127–8.547; p = 0.028), no spondylolisthesis (OR, 2.976; 95% CI, 1.246–7.092; p = 0.014), no previous lumbar surgery (OR, 2.242; 95% CI, 1.067–4.716; p = 0.033), mild foraminal stenosis (OR, 3.460; 95% CI, 1.436–8.333; p = 0.006), no opioid use (OR, 1.782; 95% CI, 0.854–3.717; p = 0.123), and baseline pain scores (OR, 0.787; 95% CI, 0.583–1.064; p = 0.120) were the predictive factors significantly associated with unsuccessful treatment outcome. PEA is a useful treatment option for patients with chronic lumbar radicular pain refractory to epidural steroid injections. A history of lumbar surgery, spondylolisthesis, depression, and severe foraminal stenosis could be associated with a poor prognosis.