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

1)评价硬膜外镜术治疗腰椎病引起的顽固性腰腿痛的有效性和安全性。硬膜外粘连和/或神经根粘连松解术对18例因腰椎疾病引起的顽固性腰腿痛患者具有长期疗效，这是根据日本骨科学会(JOAcore)的评估评分和对接受治疗的患者进行的术后调查而建立的。2)神经根成形术对感觉神经功能的影响。使用神经计进行当前感觉阈值测试，以区分Aβ、Aδ和C纤维的功能，以检测神经根镜检查如何通过释放神经根上的压力或牵拉来影响神经功能。在2000赫兹相当于Aβ纤维的情况下，镜下手术使神经功能从麻木状态恢复到正常状态，证明镜下确实减轻了这种压力或对通常对压力最敏感的Aβ纤维的牵拉。此外，尽管这种药物可能仅限于那些不刺激局部组织或没有神经毒性的药物，但事实上，由于时间的限制，在本研究中，没有进行任何动物实验。

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.