{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T15:25:23Z","timestamp":1767713123445,"version":"build-2065373602"},"reference-count":36,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background: Percutaneous epidural neuroplasty (PEN) and related adhesiolysis procedures are widely used for managing chronic spinal pain. Although generally safe, complications\u2014ranging from minor to life-threatening\u2014have been reported. This review aimed to estimate the incidence and characteristics of complications following PEN and to evaluate the medical rationale for post-procedural inpatient monitoring. Methods: We systematically searched PubMed, Embase, and the Cochrane Library for studies published from January 2000 to April 2025 reporting complications associated with PEN. We performed a random-effects meta-analysis on five eligible cohort studies to estimate the pooled complication rate and evaluated heterogeneity. Risk of bias was assessed using the Newcastle\u2013Ottawa Scale. Results: Five cohort studies (n = 1740) were included in the meta-analysis, with a pooled complication rate of 9.0% (95% CI: 4.8\u201313.1%, I2 = 97.5%). A total of 133 complications were identified from cohort studies and case reports. Mechanical and neurological complications were most common. Serious complications, including hematoma, meningitis, and cardiopulmonary arrest, were concentrated within the first 6 h post-procedure. Conclusions: This meta-analysis highlights a quantifiable risk of complications associated with PEN. Our findings support structured inpatient monitoring during the immediate post-procedural period to enhance safety and outcomes.<\/jats:p>","DOI":"10.3390\/medicina61081397","type":"journal-article","created":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T08:51:41Z","timestamp":1754038301000},"page":"1397","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Complications Following Percutaneous Epidural Neuroplasty: A Narrative Review of Clinical Evidence and the Rationale for Post-Procedural 6 h Inpatient Monitoring Amid Limited Systematic Data"],"prefix":"10.3390","volume":"61","author":[{"given":"Jae Hun","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Konkuk University School of Medicine, Seoul 05030, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2092-6658","authenticated-orcid":false,"given":"Eun Jang","family":"Yoon","sequence":"additional","affiliation":[{"name":"Department of Pain Medicine, Kok Pain Clinic, Seongnam-si 13615, Gyeonggi-do, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7456-3218","authenticated-orcid":false,"given":"Sung Ho","family":"Jo","sequence":"additional","affiliation":[{"name":"Department of Neurology, Kok Pain Clinic, Seongnam-si 13615, Gyeonggi-do, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sun Ok","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Pain Medicine, Kok Pain Clinic, Seongnam-si 13615, Gyeonggi-do, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-1196-0131","authenticated-orcid":false,"given":"Dong Woo","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Kok Pain Clinic, Seongnam-si 13615, Gyeonggi-do, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-1160-4431","authenticated-orcid":false,"given":"Hwan Hee","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Pain Medicine, Kok Pain Clinic, Seongnam-si 13615, Gyeonggi-do, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"E523","DOI":"10.36076\/ppj\/2019.22.E523","article-title":"Effectiveness of Percutaneous Adhesiolysis in Managing Chronic Central Lumbar Spinal Stenosis: A Systematic Review and Meta-Analysis","volume":"22","author":"Manchikanti","year":"2019","journal-title":"Pain Physician"},{"key":"ref_2","first-page":"11303","article-title":"Assessment of efficacy of percutaneous epidural neuroplasty for lumbar stenosis and failed back surgery syndrome: Effective and safe?","volume":"27","author":"Dagistan","year":"2023","journal-title":"Eur. 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