Fluoroscopically guided transforaminal epidural dry needling for lumbar spinal stenosis using a specially designed needle

BMC Musculoskeletal Disorders

Technical Advance

Hyung-Joon Jhun¹  Tae-Kyun Lim²  Yong-Seung Lee²  Kang Ahn² 

[1] Centre for Interventional Pain Management, Daejeon Woori Hospital, 1419, Metrozone, 302-531, Doonsan-Dong, Seo-Ku, Daejeon, Republic of Korea;Chronic Pain Management Centre, Cha Biomedical Centre, Kangnam Cha Hospital, Cha University, 605, Yeoksam-Dong, Kangnam-Ku, Seoul, Republic of Korea;

关键词: Facet Joint;    Oswestry Disability Index;    Epidural Space;    Lumbar Spinal Stenosis;    Ligamentum Flavum;   

DOI  :  10.1186/1471-2474-11-180

 received in 2010-02-26, accepted in 2010-08-11,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundThis report describes the methodological approach and clinical application of a minimally invasive intervention to treat lumbar spinal stenosis (LSS).MethodsThirty-four patients with LSS underwent fluoroscopically guided transforaminal epidural dry needling using a specially designed flexed Round Needle. The needle was inserted 8-12 cm lateral to the midline at the level of the stenosis and advanced to a position between the anterior side of the facet joint and pedicle up to the outer-third of the pedicle. The needle was advanced medially and backed laterally within a few millimetres along the canal side of the inferior articular process between the facet joint and pedicle. The procedure was completed when a marked reduction in resistance was felt at the tip of the needle. The procedure was performed bilaterally at the level of the stenosis.ResultsThe average follow-up period was 12.9 ± 1.1 months. The visual analogue scale (VAS) pain score was reduced from 7.3 ± 2.0 to 4.6 ± 2.5 points, the Oswestry Disability Index (ODI) score decreased from 41.4 ± 17.2 to 25.5 ± 12.6% and the average self-rated improvement was 52.6 ± 33.1%. The VAS scores indicated that 14 (41.2%) patients reported a "good" to "excellent" treatment response, while 11 (32.4%) had a "good" to "excellent" treatment response on the ODI and 22 (64.7%) had a "good" to "excellent" treatment response on the self-rated improvement scale.ConclusionsThese results suggest that fluoroscopically guided transforaminal epidural dry needling is effective for managing LSS.

【 授权许可】

Unknown   
© Ahn et al; licensee BioMed Central Ltd. 2010. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.