Evaluation of reliability and safety of targeted treatments via epiduroscopy and their use in clinical applications.

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1)Evaluation of usefulness and safety of epiduroscopy against intractable lower back and limb pain caused by lumbar diseases. Epiduroscopy radiculoplasty that lyses of epidural adhesion and/or nerve root adhesion was found to have long-lasting effectiveness on 18 patients suffering from intractable lower back and limb pain caused by lumbar diseases, which was established based on evaluation scores developed by the Japanese Orthopaedic Association (JOAscore) and a post-operative survey conducted among the treated patients. Safety of the operations was confirmed with the absence of complications among the patients.2)Effects of radiculoplasty on sensory nerve functions.Current perception threshold (CPT) tests using Neurometer that can differentiate functions of Aβ,Aδ, and C fibers were performed to examine how epiduroscopy would affect the nerve functions by releasing pressure or traction present on the nerve roots. At 2000Hz that corresponds to Aβ fibers, the epiduroscopic operation improved the nerve function from torpor to normal, which proved epiduroscopy indeed alleviate such pressure or traction on the Aβ fiber that is usually most susceptible to pressure. Further, the fact that epiduroscopy actually reaches the nerve root opens a possibility to selectively administer drugs, albeit such drugs may be limited to those that do not irritate local tissue or those without neurotoxicity.3)In the present study, no animal experiment was performed due to time constraints.