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Ito Z, Shibayama M, Nakamura S, Yamada M, Kawai M, Shimizu K, Takuechi M, Yoshimatsu H, Kuraishi K, Hoshi N, Taguchi M, Miura Y, Ito F. Postoperative Outcomes After Transsacral Epiduroscopic Laser Decompression in Japanese Patients: Denervation Therapy for Discogenic Low-Back Pain. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2020; 38:507-511. [PMID: 32780687 DOI: 10.1089/photob.2019.4770] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background: Transsacral epiduroscopic laser decompression (SELD) is a very noninvasive surgery, so it is effective for elderly patients and athletes and is a new and minimally invasive therapeutic technique that may be useful in many patients with discogenic low-back pain (LBP) having high signal intensity zone (HIZ) in magnetic resonance imaging (MRI). We investigated the clinical outcomes of SELD in Japanese patients with discogenic LBP having HIZ as a first trial. Methods: The subjects consisted of 52 patients who underwent SELD and were followed up for at least 6 months. All patients with LBP with HIZ were operative using the SELD technique. Outcomes of the patients were assessed with visual analogue scale (VAS) for LBP, the Oswestry disability index (ODI), and the EuroQol 5 dimension (EQ-5D). Statistical analyses were carried out using a paired t-test. A p-value of <0.05 was considered significant. For statistical analysis, we used the SPSS software program. Results: At 12 months after the procedure, the average VAS score for LBP fell to 1.2 from 5.6 (p-value <0.05). The ODI score also dropped from the preoperative level of 22.3 to 8.8. The EQ-5D score also significantly increased from the preoperative level of 0.865 (SD 0.10) to 0.950 (SD 0.05). Eight cases of intraoperative cervical pain were observed as complications with no cases of hematomas, infections, and postoperative neurosis was observed. Conclusions: SELD provides a novel minimally invasive technique capable of performing multilevel intervertebral surgery. We believe that SELD is an effective method of treating discogenic LBP due to HIZs.
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Affiliation(s)
- Zenya Ito
- Aichi Spine Hospital, Department of Orthopedic Surgery, Nagoya, Japan
| | | | - Shu Nakamura
- Aichi Spine Hospital, Department of Orthopedic Surgery, Nagoya, Japan
| | - Minoru Yamada
- Aichi Spine Hospital, Department of Orthopedic Surgery, Nagoya, Japan
| | - Masaki Kawai
- Aichi Spine Hospital, Department of Orthopedic Surgery, Nagoya, Japan
| | - Kenzo Shimizu
- Aichi Spine Hospital, Department of Orthopedic Surgery, Nagoya, Japan
| | - Mikinobu Takuechi
- Aichi Spine Hospital, Department of Orthopedic Surgery, Nagoya, Japan
| | - Hiroki Yoshimatsu
- Aichi Spine Hospital, Department of Orthopedic Surgery, Nagoya, Japan
| | - Keita Kuraishi
- Aichi Spine Hospital, Department of Orthopedic Surgery, Nagoya, Japan
| | - Naoto Hoshi
- Aichi Spine Hospital, Department of Orthopedic Surgery, Nagoya, Japan
| | - Mitsuto Taguchi
- Aichi Spine Hospital, Department of Orthopedic Surgery, Nagoya, Japan
| | - Yasushi Miura
- Aichi Spine Hospital, Department of Orthopedic Surgery, Nagoya, Japan
| | - Fujio Ito
- Aichi Spine Hospital, Department of Orthopedic Surgery, Nagoya, Japan
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Shimada N, Igarashi T, Murai K, Hara T, Kuramochi T, Takeuchi M. Adhesions in the epidural space caused by frequent epidural blocks. JA Clin Rep 2017; 3:57. [PMID: 29457101 PMCID: PMC5804652 DOI: 10.1186/s40981-017-0128-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Accepted: 10/05/2017] [Indexed: 11/13/2022] Open
Abstract
We report a case of adhesions in the epidural space caused by more than 200 times epidural blocks that were observed with epiduroscopy. A 41-year-old man had repeatedly undergone lumbar epidural blocks to treat pain in his leg, resulting in decreased efficacy of the epidural block. We described endoscopic findings that these adhesions were mostly consisted of adhesions formed from the soft connective tissue.
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Affiliation(s)
- Nobuhiro Shimada
- Department of Anesthesiology and Critical Care Medicine, Jichi Medical University, 3311-1, Yakushiji, Shimotsuke, Tochigi 329-0498 Japan
| | - Takashi Igarashi
- Department of Anesthesiology and Critical Care Medicine, Jichi Medical University, 3311-1, Yakushiji, Shimotsuke, Tochigi 329-0498 Japan
| | - Kunihiko Murai
- Department of Anesthesiology and Critical Care Medicine, Jichi Medical University, 3311-1, Yakushiji, Shimotsuke, Tochigi 329-0498 Japan
| | - Tetsuhito Hara
- Department of Anesthesiology and Critical Care Medicine, Jichi Medical University, 3311-1, Yakushiji, Shimotsuke, Tochigi 329-0498 Japan
| | - Tomoko Kuramochi
- Department of Anesthesiology and Critical Care Medicine, Jichi Medical University, 3311-1, Yakushiji, Shimotsuke, Tochigi 329-0498 Japan
| | - Mamoru Takeuchi
- Department of Anesthesiology and Critical Care Medicine, Jichi Medical University, 3311-1, Yakushiji, Shimotsuke, Tochigi 329-0498 Japan
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