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Article

Transforaminal Epidural Balloon Adhesiolysis via a Contralateral Interlaminar Retrograde Foraminal Approach: A Retrospective Analysis and Technical Considerations

by
Chan-Sik Kim
1,†,
Yeon-Jin Moon
2,†,
Jae Won Kim
3,
Dong-Min Hyun
1,
Shill Lee Son
2,
Jin-Woo Shin
1,
Doo-Hwan Kim
1,
Seong-Soo Choi
1,* and
Myong-Hwan Karm
4,*
1
Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
2
Department of Anesthesiology and Pain Medicine, National Medical Center, Seoul 04564, Korea
3
Department of Anesthesiology and Pain Medicine, Eulji University Medical Center, Eulji University College of Medicine, Daejeon 35233, Korea
4
Department of Dental Anesthesiology, Seoul National University Dental Hospital, Seoul 03080, Korea
*
Authors to whom correspondence should be addressed.
†
These authors contributed equally to this project.
J. Clin. Med. 2020, 9(4), 981; https://doi.org/10.3390/jcm9040981
Submission received: 5 March 2020 / Revised: 26 March 2020 / Accepted: 1 April 2020 / Published: 1 April 2020
(This article belongs to the Special Issue Interventional Procedures for Chronic Spinal Pain)
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Abstract

Several treatment modalities have been proposed for foraminal stenosis, but the treatment options remain unsatisfactory. Previous studies have shown that transforaminal balloon adhesiolysis may be effective in patients with refractory lumbar foraminal stenosis. However, in patients with a high iliac crest, balloon catheter insertion may be difficult via a conventional transforaminal approach (particularly targeting the L5–S1 foramen). It has been reported that an epidural catheter can be placed easily by a contralateral interlaminar retrograde foraminal approach. Therefore, we applied this approach to L5–S1 transforaminal balloon adhesiolysis in patients with a high iliac crest. We retrospectively analyzed data from 22 patients who underwent combined epidural adhesiolysis and balloon decompression (balloon adhesiolysis) using the novel foraminal balloon catheter via a contralateral interlaminar retrograde foraminal approach. The pain intensity significantly decreased over the three-month period after balloon adhesiolysis (p < 0.001). There were no complications associated with the balloon procedure. The present study suggests that balloon adhesiolysis for L5-S1 foramen via a contralateral interlaminar retrograde foraminal approach may be an effective alternative for patients with a high iliac crest and refractory lumbar radicular pain due to lumbar foraminal stenosis. In addition, detailed procedural aspects are described here.
Keywords: chronic pain; epidural balloon adhesiolysis; interlaminar; retrograde; lumbar spinal stenosis chronic pain; epidural balloon adhesiolysis; interlaminar; retrograde; lumbar spinal stenosis

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MDPI and ACS Style

Kim, C.-S.; Moon, Y.-J.; Kim, J.W.; Hyun, D.-M.; Son, S.L.; Shin, J.-W.; Kim, D.-H.; Choi, S.-S.; Karm, M.-H. Transforaminal Epidural Balloon Adhesiolysis via a Contralateral Interlaminar Retrograde Foraminal Approach: A Retrospective Analysis and Technical Considerations. J. Clin. Med. 2020, 9, 981. https://doi.org/10.3390/jcm9040981

AMA Style

Kim C-S, Moon Y-J, Kim JW, Hyun D-M, Son SL, Shin J-W, Kim D-H, Choi S-S, Karm M-H. Transforaminal Epidural Balloon Adhesiolysis via a Contralateral Interlaminar Retrograde Foraminal Approach: A Retrospective Analysis and Technical Considerations. Journal of Clinical Medicine. 2020; 9(4):981. https://doi.org/10.3390/jcm9040981

Chicago/Turabian Style

Kim, Chan-Sik, Yeon-Jin Moon, Jae Won Kim, Dong-Min Hyun, Shill Lee Son, Jin-Woo Shin, Doo-Hwan Kim, Seong-Soo Choi, and Myong-Hwan Karm. 2020. "Transforaminal Epidural Balloon Adhesiolysis via a Contralateral Interlaminar Retrograde Foraminal Approach: A Retrospective Analysis and Technical Considerations" Journal of Clinical Medicine 9, no. 4: 981. https://doi.org/10.3390/jcm9040981

APA Style

Kim, C.-S., Moon, Y.-J., Kim, J. W., Hyun, D.-M., Son, S. L., Shin, J.-W., Kim, D.-H., Choi, S.-S., & Karm, M.-H. (2020). Transforaminal Epidural Balloon Adhesiolysis via a Contralateral Interlaminar Retrograde Foraminal Approach: A Retrospective Analysis and Technical Considerations. Journal of Clinical Medicine, 9(4), 981. https://doi.org/10.3390/jcm9040981

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