EVALUATION OF THE EFFICACY OF PERCUTANEOUS CAUDAL AND COMBINED CAUDAL/TRANSFORAMINAL NEUROPLASTYADESIOLYSIS FOR TREATING SYMPTOMATIC LUMBAR SPINAL STENOSIS

Abstract

Objective: Lumbar spinal stenosis (LSS) is a narrowing of the canal diameter due to degenerative changes, particularly in elderly individuals. This narrowing sometimes accompanies foraminal stenosis. The aim of this study was to investigate the efficacy of caudal and combined caudal/transforaminal adhesiolysis for treating symptomatic LSS patients. Materials and Methods: Patients between the ages of 48-74, whose diagnosis was confirmed by magnetic resonance imaging were included in the study. The gender distribution was kept the same in both groups. The procedure was initially performed through the caudal way in all patients. Patients, with no evidence of foraminal passage in epidurography were categorized in group 2 as a combined caudal and transforaminal adhesiolysis groups. A total of 80 patients (40 patients in each group) were included in this study. Pain relief was evaluated using the walking distance, visual analog scale (VAS), and Oswestry Disability Index (ODI) before the procedure (baseline) and at the second week, the third and the sixth months after the procedure. Results: Baseline VAS values were found to be at least 5 and higher in the patients without foraminal passage by epidurography. These values were present in 35% of the patients in the caudal group. The increase in walking distance was similar in both groups (72.5% in the caudal group and 75% in the combined group). The improvement in VAS was significant in the combined group, and was observed in 39 of 40 patients. The improvement in ODI was 97.5% in both groups. No complications were encountered during and after the procedures. Conclusion: Caudal neuroplasty adhesiolysis is an effective method for treating chronic low back pain due to symptomatic LSS and its effectiveness is increased when adding a transforaminal procedures in cases with no foraminal passage in epidurography. © Copyright 2023 by the Turkish Spine Society.