{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T18:45:21Z","timestamp":1787510721129,"version":"build-2736575974"},"reference-count":27,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2020,4,16]],"date-time":"2020-04-16T00:00:00Z","timestamp":1586995200000},"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>Post-laminectomy syndrome (PLS) is characterized by chronic pain and complex pathological entity after back surgery. An epidural adhesiolysis is considered an effective treatment option for lumbar PLS. In this study, we retrospectively analyzed the outcome and evaluated the predictive factors of combined epidural adhesiolysis and balloon decompression using inflatable balloon catheters in lumbar PLS cases. One hundred and forty-seven subjects were retrospectively assessed and analyzed. The percentages of patients who exhibited treatment response were 32.0%, 24.5%, and 22.4% of the study population at 1, 3, and 6 months, respectively. In multivariate logistic regression analysis, the pain duration was independently associated with the treatment response six months after combined epidural adhesiolysis and balloon decompression (odds ratio = 0.985, 95% confidence interval = 0.971\u20130.999; p = 0.038). In addition, the receiver operating characteristic curve analysis showed that the area under the curve of pain duration after lumbar surgery was 0.680 (95% confidence interval = 0.597\u20130.754, p = 0.002), with an optimal cut-off value of \u226414 months, sensitivity of 51.5%, and specificity of 81.4% Our results suggest that an early intervention using combined epidural adhesiolysis and balloon decompression in lumbar PLS patients may be associated with a favorable outcome, even though it has limited effectiveness.<\/jats:p>","DOI":"10.3390\/jcm9041144","type":"journal-article","created":{"date-parts":[[2020,4,16]],"date-time":"2020-04-16T13:01:39Z","timestamp":1587042099000},"page":"1144","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Effectiveness of and Factors Associated with Balloon Adhesiolysis in Patients with Lumbar Post-Laminectomy Syndrome: A Retrospective Study"],"prefix":"10.3390","volume":"9","author":[{"given":"Yul","family":"Oh","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5225-4083","authenticated-orcid":false,"given":"Dong Ah","family":"Shin","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Spine and Spinal Cord Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong Joon","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":[{"vocabulary":"crossref","role":"author"}]},{"given":"Woojong","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taejun","family":"Na","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeong-Gil","family":"Leem","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"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":[{"vocabulary":"crossref","role":"author"}]},{"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":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0423-3616","authenticated-orcid":false,"given":"Kyung-Don","family":"Hahm","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"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":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,4,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Oster, B.A., Kikanloo, S.R., Levine, N.L., Lian, J., and Cho, W. (2019). Systematic Review of Outcomes Following 10-Year Mark of Spine Patient Outcomes Research Trial (SPORT) for Spinal Stenosis. Spine.","DOI":"10.1097\/BRS.0000000000003323"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1016\/j.spinee.2014.12.008","article-title":"Comparison of the lumbar disc herniation patients randomized in SPORT to 6,846 discectomy patients from NSQIP: Demographics, perioperative variables, and complications correlate well","volume":"15","author":"Golinvaux","year":"2015","journal-title":"Spine J."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1097\/BRS.0000000000000088","article-title":"Surgical versus nonoperative treatment for lumbar disc herniation: Eight-year results for the spine patient outcomes research trial","volume":"39","author":"Lurie","year":"2014","journal-title":"Spine"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1097\/00007632-199603010-00017","article-title":"The failed back surgery syndrome: Reasons, intraoperative findings, and long-term results: A report of 182 operative treatments","volume":"21","author":"Fritsch","year":"1996","journal-title":"Spine"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"574","DOI":"10.4184\/asj.2018.12.3.574","article-title":"Etiology, Evaluation, and Treatment of Failed Back Surgery Syndrome","volume":"12","author":"Sebaaly","year":"2018","journal-title":"Asian Spine J."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1097\/BRS.0000000000002217","article-title":"Treatment Options for Failed Back Surgery Syndrome Patients with Refractory Chronic Pain: An Evidence Based Approach","volume":"42","author":"Amirdelfan","year":"2017","journal-title":"Spine"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"29","DOI":"10.36076\/ppj.2017.1.E29","article-title":"Treatment Outcomes for Patients with Failed Back Surgery","volume":"20","author":"Cho","year":"2017","journal-title":"Pain Physician"},{"key":"ref_8","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_9","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_10","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"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1097\/j.pain.0000000000001433","article-title":"The IASP classification of chronic pain for ICD-11: Functioning properties of chronic pain","volume":"160","author":"Nugraha","year":"2019","journal-title":"Pain"},{"key":"ref_12","first-page":"16","article-title":"Failed back surgery syndrome: What\u2019s in a name? A proposal to replace \u201cFBSS\u201d by \u201cPOPS\u201d","volume":"61","author":"Rigoard","year":"2015","journal-title":"Neuro-Chir."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1227\/00006123-199105000-00008","article-title":"Failed back surgery syndrome: 5-year follow-up in 102 patients undergoing repeated operation","volume":"28","author":"North","year":"1991","journal-title":"Neurosurgery"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1177\/2049463712466321","article-title":"Diagnosis and treatment of failed back surgery syndrome in the UK: Mapping of practice using a cross-sectional survey","volume":"6","author":"Tharmanathan","year":"2012","journal-title":"Br. J. Pain"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1016\/j.spinee.2010.02.025","article-title":"Failed back syndrome and epidural fibrosis","volume":"10","author":"Rabb","year":"2010","journal-title":"Spine J."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"642","DOI":"10.4184\/asj.2017.11.4.642","article-title":"Neuropathic Pain after Spinal Surgery","volume":"11","author":"Cho","year":"2017","journal-title":"Asian Spine J."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1111\/j.1533-2500.2005.05304.x","article-title":"Interdisciplinary treatment of failed back surgery syndrome (FBSS): A comparison of FBSS and non-FBSS patients","volume":"5","author":"Miller","year":"2005","journal-title":"Pain Pract."},{"key":"ref_18","first-page":"501","article-title":"Comparison of 3 Approaches to Percutaneous Epidural Adhesiolysis and Neuroplasty in Post Lumbar Surgery Syndrome","volume":"21","author":"Akbas","year":"2018","journal-title":"Pain Physician"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"361","DOI":"10.36076\/ppj.2009\/12\/361","article-title":"Systematic review of percutaneous adhesiolysis and management of chronic low back pain in post lumbar surgery syndrome","volume":"12","author":"Epter","year":"2009","journal-title":"Pain Physician"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"419","DOI":"10.36076\/ppj.2009\/12\/419","article-title":"Effectiveness of spinal endoscopic adhesiolysis in post lumbar surgery syndrome: A systematic review","volume":"12","author":"Hayek","year":"2009","journal-title":"Pain Physician"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Rapcan, R., Kocan, L., Mlaka, J., Burianek, M., Kocanova, H., Rapcanova, S., Hess, M., Hammond, A., Griger, M., and Venglarcik, M. (2018). A Randomized, Multicenter, Double-Blind, Parallel Pilot Study Assessing the Effect of Mechanical Adhesiolysis vs Adhesiolysis with Corticosteroid and Hyaluronidase Administration into the Epidural Space during Epiduroscopy. Pain Med.","DOI":"10.1093\/pm\/pnx328"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1093\/pm\/pny233","article-title":"Efficacy, Effectiveness, Safety, and Cost-effectiveness of Epidural Adhesiolysis for Treating Failed Back Surgery Syndrome. A Systematic Review","volume":"20","author":"Kovacs","year":"2019","journal-title":"Pain Med."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Karm, M.H., Yoon, S.H., Seo, D.K., Lee, S., Lee, Y., Cho, S.S., and Choi, S.S. (2019). Combined epidural adhesiolysis and balloon decompression can be effective in intractable lumbar spinal stenosis patients unresponsive to previous epidural adhesiolysis. Medicine, 98.","DOI":"10.1097\/MD.0000000000015114"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"109","DOI":"10.3344\/kjp.2018.31.2.109","article-title":"The outcome of epiduroscopy treatment in patients with chronic low back pain and radicular pain, operated or non-operated for lumbar disc herniation: A retrospective study in 88 patients","volume":"31","author":"Hazer","year":"2018","journal-title":"Korean J. Pain"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1097\/BRS.0000000000002385","article-title":"Preoperative Opioid Use is a Predictor of Poor Return to Work in Workers\u2019 Compensation Patients After Lumbar Diskectomy","volume":"43","author":"Anderson","year":"2018","journal-title":"Spine"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/j.pmrj.2013.03.015","article-title":"Evaluating the patient with suspected radiculopathy","volume":"5","author":"Dillingham","year":"2013","journal-title":"PM&R"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1055\/s-2003-40754","article-title":"Pearls and pitfalls in the use of electromyography and nerve conduction studies","volume":"23","author":"Gutmann","year":"2003","journal-title":"Semin. Neurol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/9\/4\/1144\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T14:09:15Z","timestamp":1760364555000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/9\/4\/1144"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,4,16]]},"references-count":27,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2020,4]]}},"alternative-id":["jcm9041144"],"URL":"https:\/\/doi.org\/10.3390\/jcm9041144","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,4,16]]}}}