Percutaneous endoscopic foraminal decompression for persistent radiculopathic leg pain for foraminal stenosis after osteoporotic lumbar vertebral compression fracture
EANS Academy. Ju C. 09/25/19; 275630; EP02011
Prof. Dr. Chang-Il Ju
Prof. Dr. Chang-Il Ju

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Introduction: Osteoporotic vertebral compression fractures (VCFs) in the elderly patient can cause significant pain and lead to restrict their daily life activities. Augmentation procedures (Vertebroplasty(VP) and kyphoplasty(KP)) have reported as a standard treatment of VCFs in cases of not responding to conservative treatment. However, the radiculopathic leg pain may persist even after augmentation procedures due to foraminal stenotic change. We have tried to decompress the exiting nerve root by endoscopic foraminal decompression.
Material and methods: 15 patients with persistent radiating leg pain after augmentation procedures of 56 patients were surveyed. We judged the radiculopathic pain of foraminal stenosis due to compression fracture by MR images and nerve root block. Percutaneous endoscopic foraminal decompression was done after selective exiting nerve root block to confirm exiting nerve radiculopathic pain. All remnant pain patients were evaluated at interval of 1-2 weeks and added injection if they had pain.
Results: Back Pain intensity using VAS (visual analog scale) was decreased, from 8.5 before augmentation procedures to 3.2 after augmentation procedures. But radiating pain was not changed significantly (VAS : 7.6). After endoscopic foraminal decompression, VAS decrease from 7.6 to below 2.7. Successful outcome was determined if pain reduction exceeded 50% relief. 13 of the 15 patients (86.7%) showed successful responses.
Conclusion: Endoscopic foraminal decompression is the one of the effective methods to resolve the persistent radiculopathic leg pain after augmentation procedures in the patients with osteoprotic veretebral compression fracture.
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