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Fluoroscopically guided transforaminal epidural dry needling for lumbar spinal stenosis using a specially designed needle

DOI: 10.1186/1471-2474-11-180

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Abstract:

Thirty-four patients with LSS underwent fluoroscopically guided transforaminal epidural dry needling using a specially designed flexed Round Needle. The needle was inserted 8-12 cm lateral to the midline at the level of the stenosis and advanced to a position between the anterior side of the facet joint and pedicle up to the outer-third of the pedicle. The needle was advanced medially and backed laterally within a few millimetres along the canal side of the inferior articular process between the facet joint and pedicle. The procedure was completed when a marked reduction in resistance was felt at the tip of the needle. The procedure was performed bilaterally at the level of the stenosis.The average follow-up period was 12.9 ± 1.1 months. The visual analogue scale (VAS) pain score was reduced from 7.3 ± 2.0 to 4.6 ± 2.5 points, the Oswestry Disability Index (ODI) score decreased from 41.4 ± 17.2 to 25.5 ± 12.6% and the average self-rated improvement was 52.6 ± 33.1%. The VAS scores indicated that 14 (41.2%) patients reported a "good" to "excellent" treatment response, while 11 (32.4%) had a "good" to "excellent" treatment response on the ODI and 22 (64.7%) had a "good" to "excellent" treatment response on the self-rated improvement scale.These results suggest that fluoroscopically guided transforaminal epidural dry needling is effective for managing LSS.Lumbar spinal stenosis (LSS) is a painful and potentially disabling condition that is defined as a narrowing of the lumbar spinal canal, nerve root canal or intervertebral foramina. It is often encountered in the geriatric population. The primary causes of spinal canal constriction are a protruding intervertebral disc, hypertrophied facet joint and thickened ligamentum flavum [1].Patients suffering from LSS develop pain, paraesthesias, numbness and weakness in the back and legs caused by compression of the lumbosacral nerve roots in the constricted neural canal and foramina [2]. Neurogenic claudication, the most commo

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