Percutaneous Epidural Adhesiolysis of Lumbar Spinal Stenosis

Abstract

Percutaneous epidural neuroplasty (PEN) represents an important part of the interventional repertoire for the treatment of low back pain which is refractory to conventional treatments such as epidural steroid injections (ESI). PEN has been done worldwildey. The evidence surrounding epidural neuroplasty is still controversial, but, many studies support ambulatory PEN for failed back surgery syndrome, spinal stenosis and radicular pain refractory to less invasive procedures. The primary purpose of PEN is to deliver anesthetic, anti-inflammatory, and/or anti-adhesive drugs in addition to mechanical adhesiolysis. Hydrostatic and chemical adhesiolysis may contribute to the beneficial effect of adhesiolysis. Identifying the ideal patients and technique for PEN is important to maximize its effectiveness. The cumulative evidence shows that PEN is an effective treatment for spinal stenosis.