Efficacy of Epidural Balloon Neuroplasty According to Spondylolisthesis Grade

Abstract

Background: Degenerative spondylolisthesis (DS) is the most common causes of mechanical compression of spinal nerve roots. The compression of these nerve roots can lead to low back pain and/or leg pain, as well as neurogenic claudication. Percutaneous epidural neuroplasty (PEN) or balloon neuroplasty (BNP) are established treatment for lumbar spinal pain. Objective: The aim of our study was to determine the efficacy of BNP according DS grading. Methods: This study enrolled 107 patients with grade 1 DS (n=56) or grade 2 DS (n=51). Outcome measures were obtained by using both the visual analogue scale score (VAS) for pain and Oswetry instability index (ODI) at 2 weeks, and 6 months after treatment. Limitations: Grade 3 or 4 were not included. Secondary outcomes were not assessed, and the study did not include a long-term follow up period. Results: Mean post-treatment VAS at 2 weeks and 6 months were not significantly lower in either the patients with DS 1or the patients with DS 2. In addition, difference between the two groups were not significant. Among the patients with DS1, 37% of patients had VAS > 50% at both 2 weeks and 6 months follow up. Among the patients with DS 2, 17.9% and 21% had VAS >50% at 2 weeks and 6 months follow up assessment, respectively. In the DS 1 group, there was significant correlation between pain duration and at 2 weeks using VAS. Three patients with DS 1 and three with DS 2 had done surgery after BNP. Conclusion: BNP was not a suitable treatment modality for patients with grade 1and 2 DS at the 6-month followup period.