{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T02:48:38Z","timestamp":1760237318778,"version":"build-2065373602"},"reference-count":22,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2020,4,1]],"date-time":"2020-04-01T00:00:00Z","timestamp":1585699200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Several treatment modalities have been proposed for foraminal stenosis, but the treatment options remain unsatisfactory. Previous studies have shown that transforaminal balloon adhesiolysis may be effective in patients with refractory lumbar foraminal stenosis. However, in patients with a high iliac crest, balloon catheter insertion may be difficult via a conventional transforaminal approach (particularly targeting the L5\u2013S1 foramen). It has been reported that an epidural catheter can be placed easily by a contralateral interlaminar retrograde foraminal approach. Therefore, we applied this approach to L5\u2013S1 transforaminal balloon adhesiolysis in patients with a high iliac crest. We retrospectively analyzed data from 22 patients who underwent combined epidural adhesiolysis and balloon decompression (balloon adhesiolysis) using the novel foraminal balloon catheter via a contralateral interlaminar retrograde foraminal approach. The pain intensity significantly decreased over the three-month period after balloon adhesiolysis (p &lt; 0.001). There were no complications associated with the balloon procedure. The present study suggests that balloon adhesiolysis for L5-S1 foramen via a contralateral interlaminar retrograde foraminal approach may be an effective alternative for patients with a high iliac crest and refractory lumbar radicular pain due to lumbar foraminal stenosis. In addition, detailed procedural aspects are described here.<\/jats:p>","DOI":"10.3390\/jcm9040981","type":"journal-article","created":{"date-parts":[[2020,4,2]],"date-time":"2020-04-02T13:39:34Z","timestamp":1585834774000},"page":"981","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Transforaminal Epidural Balloon Adhesiolysis via a Contralateral Interlaminar Retrograde Foraminal Approach: A Retrospective Analysis and Technical Considerations"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5038-0203","authenticated-orcid":false,"given":"Chan-Sik","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yeon-Jin","family":"Moon","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, National Medical Center, Seoul 04564, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jae Won","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Eulji University Medical Center, Eulji University College of Medicine, Daejeon 35233, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dong-Min","family":"Hyun","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shill Lee","family":"Son","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, National Medical Center, Seoul 04564, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jin-Woo","family":"Shin","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Doo-Hwan","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2333-0235","authenticated-orcid":false,"given":"Seong-Soo","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7494-4747","authenticated-orcid":false,"given":"Myong-Hwan","family":"Karm","sequence":"additional","affiliation":[{"name":"Department of Dental Anesthesiology, Seoul National University Dental Hospital, Seoul 03080, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,4,1]]},"reference":[{"key":"ref_1","first-page":"7","article-title":"Interventional techniques: Evidence-based practice guidelines in the management of chronic spinal pain","volume":"10","author":"Boswell","year":"2007","journal-title":"Pain Physician"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"233","DOI":"10.36076\/ppj.2009\/12\/233","article-title":"Systematic review of therapeutic lumbar transforaminal epidural steroid injections","volume":"12","author":"Buenaventura","year":"2009","journal-title":"Pain Physician"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.36076\/ppj.2013\/16\/S1","article-title":"An update of comprehensive evidence-based guidelines for interventional techniques in chronic spinal pain. Part I: Introduction and general considerations","volume":"16","author":"Manchikanti","year":"2013","journal-title":"Pain Physician"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1007\/s00586-011-2008-y","article-title":"Transforaminal injection of corticosteroids for lumbar radiculopathy: Systematic review and meta-analysis","volume":"21","author":"Quraishi","year":"2012","journal-title":"Eur. Spine J."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"855","DOI":"10.1227\/00006123-199604000-00053","article-title":"Association between peridural scar and recurrent radicular pain after lumbar discectomy: Magnetic resonance evaluation. ADCON-L European Study Group","volume":"38","author":"Ross","year":"1996","journal-title":"Neurosurgery"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1097\/00007632-199004000-00010","article-title":"Adhesions of the ventral lumbar dura. An adjunct source of discogenic pain?","volume":"15","author":"Parke","year":"1990","journal-title":"Spine"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"S2","DOI":"10.1007\/BF00298565","article-title":"Role of peridural fibrosis in the failed back: A review","volume":"5","author":"Robertson","year":"1996","journal-title":"Eur. Spine J."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"147","DOI":"10.3344\/kjp.2019.32.3.147","article-title":"Lumbar foraminal neuropathy: An update on non-surgical management","volume":"32","author":"Choi","year":"2019","journal-title":"Korean J. Pain"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"178","DOI":"10.3344\/kjp.2014.27.2.178","article-title":"A novel balloon-inflatable catheter for percutaneous epidural adhesiolysis and decompression","volume":"27","author":"Choi","year":"2014","journal-title":"Korean J. Pain"},{"key":"ref_10","first-page":"476","article-title":"Effectiveness and Factors Associated with Epidural Decompression and Adhesiolysis Using a Balloon-Inflatable Catheter in Chronic Lumbar Spinal Stenosis: 1-Year Follow-Up","volume":"17","author":"Choi","year":"2016","journal-title":"Pain Med."},{"key":"ref_11","first-page":"213","article-title":"Effects of transforaminal balloon treatment in patients with lumbar foraminal stenosis: A randomized, controlled, double-blind trial","volume":"16","author":"Kim","year":"2013","journal-title":"Pain Physician"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e15114","DOI":"10.1097\/MD.0000000000015114","article-title":"Combined epidural adhesiolysis and balloon decompression can be effective in intractable lumbar spinal stenosis patients unresponsive to previous epidural adhesiolysis","volume":"98","author":"Karm","year":"2019","journal-title":"Medicine"},{"key":"ref_13","first-page":"E841","article-title":"Factors Associated with Successful Responses to Transforaminal Balloon Adhesiolysis for Chronic Lumbar Foraminal Stenosis: Retrospective Study","volume":"20","author":"Kim","year":"2017","journal-title":"Pain Physician"},{"key":"ref_14","first-page":"158","article-title":"Epidural contrast flow patterns of retrograde interlaminar ventral epidural injections stratified by the final catheter tip placement","volume":"8","author":"Jeong","year":"2013","journal-title":"Anesth. Pain Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1111\/j.1533-2500.2009.00283.x","article-title":"Evaluation of epidurographic contrast patterns with fluoroscopic-guided lumbar interlaminar ventral epidural injection","volume":"9","author":"Choi","year":"2009","journal-title":"Pain Pract."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1919","DOI":"10.1097\/BRS.0b013e3181d359bd","article-title":"Qualitative grading of severity of lumbar spinal stenosis based on the morphology of the dural sac on magnetic resonance images","volume":"35","author":"Schizas","year":"2010","journal-title":"Spine"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e12791","DOI":"10.1097\/MD.0000000000012791","article-title":"Retrodiscal epidural balloon adhesiolysis through Kambin\u2019s triangle in chronic lumbar spinal stenosis: A retrospective analysis and technical considerations","volume":"97","author":"Seo","year":"2018","journal-title":"Medicine"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"323","DOI":"10.3344\/kjp.2013.26.4.323","article-title":"A new approach to neuroplasty","volume":"26","author":"Shin","year":"2013","journal-title":"Korean J. Pain"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"129","DOI":"10.36076\/ppj.2007\/10\/129","article-title":"Systematic review of effectiveness and complications of adhesiolysis in the management of chronic spinal pain: An update","volume":"10","author":"Trescot","year":"2007","journal-title":"Pain Physician"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"431","DOI":"10.4097\/kjae.2013.65.5.431","article-title":"Fluoroscopic analysis of lumbar epidural contrast spread after retrograde interlaminar ventral epidural injection (RIVEI)","volume":"65","author":"Jeong","year":"2013","journal-title":"Korean J. Anesthesiol."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Oh, Y., Kim, D.H., Park, J.Y., Ji, G.Y., Shin, D.A., Lee, S.W., Park, J.K., Shin, J.W., and Choi, S.S. (2019). Factors Associated with Successful Response to Balloon Decompressive Adhesiolysis Neuroplasty in Patients with Chronic Lumbar Foraminal Stenosis. J. Clin. Med., 8.","DOI":"10.3390\/jcm8111766"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Park, J.Y., Ji, G.Y., Lee, S.W., Park, J.K., Ha, D., Park, Y., Cho, S.S., Moon, S.H., Shin, J.W., and Kim, D.J. (2019). Relationship of Success Rate for Balloon Adhesiolysis with Clinical Outcomes in Chronic Intractable Lumbar Radicular Pain: A Multicenter Prospective Study. J. Clin. Med., 8.","DOI":"10.3390\/jcm8050606"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/9\/4\/981\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T09:14:18Z","timestamp":1760174058000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/9\/4\/981"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,4,1]]},"references-count":22,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2020,4]]}},"alternative-id":["jcm9040981"],"URL":"https:\/\/doi.org\/10.3390\/jcm9040981","relation":{},"ISSN":["2077-0383"],"issn-type":[{"type":"electronic","value":"2077-0383"}],"subject":[],"published":{"date-parts":[[2020,4,1]]}}}