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Percutaneous Foraminal Neuroplasty Using Reference Spinal Needles: Technical Description.

Victor M Silva-Ortiz1,2, Alaa Abd-Elsayed3, Jesus Medina-Razcon4

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Percutaneous neuroplasty (PNP) offers a safe and effective alternative for chronic low back pain and radiculopathy when other treatments fail. This procedure provides sustained pain relief for patients with lumbar radiculopathy due to fibrosis.

Keywords:
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Area of Science:

  • Pain Management
  • Interventional Pain Medicine
  • Neurosurgery

Background:

  • Lumbar foraminal stenosis is a frequent cause of chronic low back pain and radiculopathy.
  • Epidural steroid injections are a common treatment, but may fail in some cases.
  • Percutaneous neuroplasty (PNP) is explored as an alternative for refractory cases without clear imaging findings.

Purpose of the Study:

  • To evaluate the efficacy of PNP as a treatment for chronic low back pain and radiculopathy.
  • To present a novel procedural approach for PNP using reference spinal needles.

Main Methods:

  • Case presentation of two patients (55-year-old male, 65-year-old female) with chronic low back pain and radiculopathy.
  • Patients had normal imaging and failed transforaminal epidural steroid injections.
  • PNP was performed using reference spinal needles.

Main Results:

  • Both patients experienced sustained pain relief exceeding 50-75%.
  • The procedure was well-tolerated and demonstrated positive outcomes.

Conclusions:

  • PNP is a safe and effective alternative treatment for chronic low back pain and lumbar radiculopathy caused by fibrosis.
  • This study provides the first step-by-step procedural description of PNP using a reference spinal needle.