서울성심병원 정형외과
Purpose
To say the medical and social issues as to the percutaneous epidural adhesiolysis.
Materials and Methods
Chronological alteration of the performance was reviewed. Its superiority to the other conventional interventional therapy was reviewed. It was investigated whether the effect of its instruments and drugs coincided with its purpose from the medical and social points of view.
Results
Its fundamental purpose is adhesiolysis. The evidence, however, that adhesion is related with spinal symptoms was unclear. It seems absurd to recognize the effects of instruments and drugs before verification of symptom contribution of adhesion. According to the literatures, there was no additional benefit in using hyaluronidase, rather it brought about complications such as anaphylaxis. Hypertonic saline had serious side effects even though it improved the results. The effect of steroid did not outrun that of placebo. Local anesthetics reduced pain, but it had nothing to do with adhesion. The overstatement of its effect gave rise to confusion in therapeutic algorithm in spinal diseases. Also the suffix ‘-plasty’ which has the meaning of forming surgically is inappropriate for the procedure of some epidural injection.
Conclusion
It is necessary to clarify the purpose and action mechanism of percutaneous epidural neuroplasty and establish appropriate indications. Then the misnomer should be corrected on the bases of its possible applications.
