{"title":"46.径流模式对比剂（RPC）对使用可转向导管进行硬膜外粘连溶解术的长期疗效的影响：一项单中心观察性研究","authors":"","doi":"10.1016/j.xnsj.2024.100384","DOIUrl":null,"url":null,"abstract":"<div><h3>BACKGROUND CONTEXT</h3><p>Epidural adhesiolytic therapy using a steerable catheter has been covered by insurance in Japan since April 2018, but there is a lack of reports radiologically evaluating its therapeutic effects, leading to uncertainty.</p></div><div><h3>PURPOSE</h3><p>In this study, we investigated how the depiction of runoff pattern contrast (RPC) in intraoperative imaging (radiculography) affects treatment outcomes and report our findings.</p></div><div><h3>STUDY DESIGN/SETTING</h3><p>A single-center observational study.</p></div><div><h3>PATIENT SAMPLE</h3><p>A total of 188 cases, consisting of 89 males and 99 females with a mean age of 72.9 years, who underwent epidural adhesiolysis for complaints of lower back pain and leg pain from August 2018 to December 2021. Targeted conditions included lumbar spinal stenosis, intervertebral disc herniation, lumbar spondylolisthesis, nonspecific lower back pain, sacral cyst, failed back surgery syndrome, and multiple operation back.</p></div><div><h3>OUTCOME MEASURES</h3><p>Improvement rate based on the Visual Analog Scale (VAS).</p></div><div><h3>METHODS</h3><p>Evaluation criteria included the presence of early postoperative (1 week) symptom improvement, VAS improvement rates of 50% or more at 6 months and 1 year as effective, and comparison with the presence of RPC in intraoperative contrast radiography.</p></div><div><h3>RESULTS</h3><p>Early postoperatively, 122 cases (65%) reported subjective symptom improvement (P < 0.05), with RPC in 67 cases (55%). At 6 months, 78 cases (42%) showed effectiveness, including RPC in 53 cases (69%). After 1 year, 58 cases (31%) demonstrated effectiveness, with RPC in 47 cases (82%). Additionally, among the 41 cases (21.8%) that required surgery, RPC was absent.</p></div><div><h3>CONCLUSIONS</h3><p>The effectiveness of epidural adhesiolysis is not persistent and is often limited to a specific period. Our results suggest the potential impact of RPC on long-term outcomes, indicating the possibility of predicting treatment effectiveness based on intraoperative contrast imaging findings.</p></div><div><h3>FDA Device/Drug Status</h3><p>This abstract does not discuss or include any applicable devices or drugs.</p></div>","PeriodicalId":34622,"journal":{"name":"North American Spine Society Journal","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666548424000775/pdfft?md5=ba474e65837ad2a1bd210564b65561e8&pid=1-s2.0-S2666548424000775-main.pdf","citationCount":"0","resultStr":"{\"title\":\"46. Effect of runoff pattern contrast (RPC) on the long-term outcomes of epidural adhesiolysis using steerable catheters: a single-center observational study\",\"authors\":\"\",\"doi\":\"10.1016/j.xnsj.2024.100384\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>BACKGROUND CONTEXT</h3><p>Epidural adhesiolytic therapy using a steerable catheter has been covered by insurance in Japan since April 2018, but there is a lack of reports radiologically evaluating its therapeutic effects, leading to uncertainty.</p></div><div><h3>PURPOSE</h3><p>In this study, we investigated how the depiction of runoff pattern contrast (RPC) in intraoperative imaging (radiculography) affects treatment outcomes and report our findings.</p></div><div><h3>STUDY DESIGN/SETTING</h3><p>A single-center observational study.</p></div><div><h3>PATIENT SAMPLE</h3><p>A total of 188 cases, consisting of 89 males and 99 females with a mean age of 72.9 years, who underwent epidural adhesiolysis for complaints of lower back pain and leg pain from August 2018 to December 2021. Targeted conditions included lumbar spinal stenosis, intervertebral disc herniation, lumbar spondylolisthesis, nonspecific lower back pain, sacral cyst, failed back surgery syndrome, and multiple operation back.</p></div><div><h3>OUTCOME MEASURES</h3><p>Improvement rate based on the Visual Analog Scale (VAS).</p></div><div><h3>METHODS</h3><p>Evaluation criteria included the presence of early postoperative (1 week) symptom improvement, VAS improvement rates of 50% or more at 6 months and 1 year as effective, and comparison with the presence of RPC in intraoperative contrast radiography.</p></div><div><h3>RESULTS</h3><p>Early postoperatively, 122 cases (65%) reported subjective symptom improvement (P < 0.05), with RPC in 67 cases (55%). At 6 months, 78 cases (42%) showed effectiveness, including RPC in 53 cases (69%). After 1 year, 58 cases (31%) demonstrated effectiveness, with RPC in 47 cases (82%). Additionally, among the 41 cases (21.8%) that required surgery, RPC was absent.</p></div><div><h3>CONCLUSIONS</h3><p>The effectiveness of epidural adhesiolysis is not persistent and is often limited to a specific period. Our results suggest the potential impact of RPC on long-term outcomes, indicating the possibility of predicting treatment effectiveness based on intraoperative contrast imaging findings.</p></div><div><h3>FDA Device/Drug Status</h3><p>This abstract does not discuss or include any applicable devices or drugs.</p></div>\",\"PeriodicalId\":34622,\"journal\":{\"name\":\"North American Spine Society Journal\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S2666548424000775/pdfft?md5=ba474e65837ad2a1bd210564b65561e8&pid=1-s2.0-S2666548424000775-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"North American Spine Society Journal\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2666548424000775\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"North American Spine Society Journal","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2666548424000775","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
46. Effect of runoff pattern contrast (RPC) on the long-term outcomes of epidural adhesiolysis using steerable catheters: a single-center observational study
BACKGROUND CONTEXT
Epidural adhesiolytic therapy using a steerable catheter has been covered by insurance in Japan since April 2018, but there is a lack of reports radiologically evaluating its therapeutic effects, leading to uncertainty.
PURPOSE
In this study, we investigated how the depiction of runoff pattern contrast (RPC) in intraoperative imaging (radiculography) affects treatment outcomes and report our findings.
STUDY DESIGN/SETTING
A single-center observational study.
PATIENT SAMPLE
A total of 188 cases, consisting of 89 males and 99 females with a mean age of 72.9 years, who underwent epidural adhesiolysis for complaints of lower back pain and leg pain from August 2018 to December 2021. Targeted conditions included lumbar spinal stenosis, intervertebral disc herniation, lumbar spondylolisthesis, nonspecific lower back pain, sacral cyst, failed back surgery syndrome, and multiple operation back.
OUTCOME MEASURES
Improvement rate based on the Visual Analog Scale (VAS).
METHODS
Evaluation criteria included the presence of early postoperative (1 week) symptom improvement, VAS improvement rates of 50% or more at 6 months and 1 year as effective, and comparison with the presence of RPC in intraoperative contrast radiography.
RESULTS
Early postoperatively, 122 cases (65%) reported subjective symptom improvement (P < 0.05), with RPC in 67 cases (55%). At 6 months, 78 cases (42%) showed effectiveness, including RPC in 53 cases (69%). After 1 year, 58 cases (31%) demonstrated effectiveness, with RPC in 47 cases (82%). Additionally, among the 41 cases (21.8%) that required surgery, RPC was absent.
CONCLUSIONS
The effectiveness of epidural adhesiolysis is not persistent and is often limited to a specific period. Our results suggest the potential impact of RPC on long-term outcomes, indicating the possibility of predicting treatment effectiveness based on intraoperative contrast imaging findings.
FDA Device/Drug Status
This abstract does not discuss or include any applicable devices or drugs.
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