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Evaluating the Technical Specifications and Clinical Performance of Different Percutaneous Epidural Neuroplasty Catheters
Neurospine. 2025;22(2):465-472.   Published online June 30, 2025
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Evaluating the Technical Specifications and Clinical Performance of Different Percutaneous Epidural Neuroplasty Catheters
Neurospine. 2025;22(2):465-472.   Published online June 30, 2025
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Objective
This study aimed to evaluate and compare the structural and functional characteristics of commercially available percutaneous epidural neuroplasty (PEN) catheters. Correlations among catheter properties were also examined to identify potential implications for clinical practice.
Methods
Nine PEN catheter products from different manufacturers were analyzed. Various physical properties were assessed, including catheter diameter, length, lever rotation angle, bending degree, and advancing force. Bending degree was measured at maximal and half-maximal lever rotation angles, with and without the guidewire inserted. Advancing force was determined by measuring pressure generated at the catheter tip upon contact with the electronic scale plate. Wilcoxon signed-rank and Spearman correlation tests were used for statistical analysis.
Results
Catheters exhibited considerable variations in structural and functional properties. The average catheter diameter and length were 2.0±0.6 mm and 287.8±30.3 mm, respectively; the mean lever rotation angle was 57°±21°. When the steering lever was rotated to its maximum allowable angle, proximal bend angle significantly increased in the wire-off state relative to the wire-on state, suggesting a trade-off between flexibility and structural support. Advancing force significantly varied across products; a positive correlation was observed between catheter diameter and advancing force.
Conclusion
This study identified substantial variations in catheter characteristics across different products. Increased catheter flexibility after guidewire removal may lead to positional instability, requiring careful consideration during PEN procedures. Larger catheter diameters were correlated with increased advancing force, which could influence ease of insertion and patient comfort. These findings emphasize the need for standardized PEN catheter specifications to optimize safety and efficacy in clinical practice.
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Weekend Admission Increases Risk of Readmissions Following Elective Cervical Spinal Fusion
Neurospine. 2023;20(1):290-300.   Published online March 31, 2023
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Weekend Admission Increases Risk of Readmissions Following Elective Cervical Spinal Fusion
Neurospine. 2023;20(1):290-300.   Published online March 31, 2023
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Objective
The “weekend effect” occurs when patients cared for during weekends versus weekdays experience worse outcomes. But reasons for this effect are unclear, especially amongst patients undergoing elective cervical spinal fusion (ECSF). Our aim was to analyze whether index weekend admission affects 30- and 90-day readmission rates post-ECSF.
Methods
All ECSF patients > 18 years were retrospectively identified from the 2016–2018 Healthcare Cost and Utilization Project Nationwide Readmissions Database (NRD), using unique patient linkage codes and International Classification of Diseases, Tenth Revision codes. Patient demographics, comorbidities, and outcomes were analyzed. Univariate logistic regression analyzed primary outcomes of 30- and 90-day readmission rates in weekday or weekend groups. Multivariate regression determined the impact of complications on readmission rates.
Results
Compared to the weekday group (n = 125,590), the weekend group (n = 1,026) held a higher percentage of Medicare/Medicaid insurance, incurred higher costs, had longer length of stay, and fewer routine home discharge (all p < 0.001). There was no difference in comorbidity burden between weekend versus weekday admissions, as measured by the Elixhauser Comorbidity Index (p = 0.527). Weekend admissions had higher 30-day (4.30% vs. 7.60%, p < 0.001) and 90-day (7.80% vs. 16.10%, p < 0.001) readmission rates, even after adjusting for sex, age, insurance status, and comorbidities. All-cause complication rates were higher for weekend admissions (8.62% vs. 12.7%, p < 0.001), specifically deep vein thrombosis, infection, neurological conditions, and pulmonary embolism.
Conclusion
Index weekend admission increases 30- and 90-day readmission rates after ECSF. In patients undergoing ECSF on weekends, postoperative care for patients at risk for specific complications will allow for improved outcomes and health care utilization.

Citations

Citations to this article as recorded by  Crossref logo
  • Weekend versus Weekday Procedures for Total Knee Arthroplasty
    Tiffany Lee, David Momtaz, Youssef Khalafallah, Alexandra Mclennan, Abdullah Ghali, Philip Ghobrial, Roberto Gonzalez, Ali Seifi, Khaled Saleh
    The Journal of Knee Surgery.2025; 38(09): 477.     CrossRef
  • Incidence and predictors of acute kidney injury after elective surgery for lumbar degenerative disease: A 13-year analysis of the US Nationwide Inpatient Sample
    Yueh-Ying Hsieh, Lien-Chen Wu, I-Chun Chen, Chang-Jung Chiang
    Journal of the Chinese Medical Association.2024; 87(4): 400.     CrossRef
  • 6,937 View
  • 137 Download
  • 2 Web of Science
  • 2 Crossref

Clinical Article

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The Comparisons of Surgical Outcomes and Clinical Characteristics between the Far Lateral Lumbar Disc Herniations and the Paramedian Lumbar Disc Herniations
Korean J Spine. 2013;10(3):155-159.   Published online September 30, 2013
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The Comparisons of Surgical Outcomes and Clinical Characteristics between the Far Lateral Lumbar Disc Herniations and the Paramedian Lumbar Disc Herniations
Korean J Spine. 2013;10(3):155-159.   Published online September 30, 2013
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Objective

The purpose of this study is to analyze clinical characteristics and surgical outcomes of the far lateral and the paramedian disc herniations.

Methods

The 88 patients who underwent an operation for lumbar disc herniations were reviewed. Visual analogue scale of leg and back pain, occurrence of sensory dysesthesia and motor deficit before and after operations were used to compare the far lateral with the paramedian disc herniations.

Results

Statistically, the far lateral herniations had more severe radicular leg pain and showed more frequent occurrence of sensory dysesthesia than paramedian herniations before operation (p<0.05). In the far lateral herniation group, preoperatively, 15 patients (75%) had sensory dysesthesia and among them, 4 patients (27%) showed improvement. In the paramedian herniation group, preoperatively, 25 patients (37%) had sensory dysesthesia and among them, 21 patients (84%) showed improvement. The degree of improvement in sensory dysesthesia was statistically higher in paramedian herniation group (p<0.05). In the far lateral herniation group, preoperatively, 11 patients (55%) had motor deficit and among them, 10 patients (91%) showed improvement. In the paramedian herniations, preoperatively, 29 patients (43%) had motor deficit and among them, 25 patients (86%) showed improvement. The degree of improvement in motor deficit was not statistically significant between groups (p>0.05).

Conclusion

Preoperatively, the far lateral herniations had more severe radicular leg pain and frequent occurrence of sensory dysesthesia. Postoperatively, the sensory dysesthesia was less improved and back pain was more severe in the far lateral herniations.

Citations

Citations to this article as recorded by  Crossref logo
  • Minimally Invasive Tubular Diskectomy for a Left L4/5 Far Lateral Disk Herniation: 2-Dimensional Operative Video
    Noah Willett, Mousa K. Hamad, Chibuikem A. Ikwuegbuenyi, Roger Härtl
    Operative Neurosurgery.2026; 30(5): 794.     CrossRef
  • MODIFIED PARAMEDIAN APPROACH FOR FAR LATERAL LUMBAR DISC HERNIATION: RETROSPECTIVE ANALYSIS OF A STABILITY-PRESERVING, FACET/PARS-SPARING SERIES
    Ümit Kocaman, Durmuş Oğuz Karakoyun, Emre Çavuşoğlu
    Journal of Turkish Spinal Surgery.2026;[Epub]     CrossRef
  • Extraforaminal versus central lumbar disc herniations: clinical features and surgical outcome comparing data from a national spine registry (NORspine)
    João André Barroso Pereira Roque dos Reis, Greger Lønne, Oliver Grundnes, Ole Kristian Alhaug
    The Spine Journal.2026;[Epub]     CrossRef
  • Transforaminal endoscopic lumbar discectomy versus interlaminar endoscopic lumbar discectomy for lumbar disc herniations: a prospective multicenter study of recovery trajectories using high-frequency patient-reported outcome measures
    Paula K. Krause, Jannik Leyendecker, Cathryn Payne, Nguyen T. Tran, Albert Teilfeian, Peter B. Derman, John Ogunlade, Saqib Hasan, Sanjay Konakondla, Meng Huang, Raymond Joseph Gardocki, Mark Mahan, Imad Khan, Anubhav Amin, Jan Bredow, Christoph P. Hofste
    The Spine Journal.2026; 26(8): 1518.     CrossRef
  • Lumbar Disc Features Predictive of Favorable Response to Transforaminal Epidural Steroid Injection: a Comprehensive Review
    Alexander Kervyn De Volkaersbeke, Sudeep Peddireddy, Gabriel Howard, Behnum Habibi
    Current Pain and Headache Reports.2026;[Epub]     CrossRef
  • Comparing Patient-Reported Outcomes of Lateral to Paramedian Lumbar Disc Herniation: A Propensity Score–Matched Observational Study
    Gustav Østerheden Andersen, Stefan Milosevic, Mads Moss Jensen, Leah Carreon, Casper Friis Pedersen, Mikkel Østerheden Andersen, Peter Helmig
    World Neurosurgery.2025; 195: 123641.     CrossRef
  • Percutaneous endoscopic lumbar discectomy for extreme lateral lumbar disc herniation
    Thomas Luebbers, Albatol Ali, Rainer Baalmann, Aydemir Kale
    Surgical Neurology International.2025; 16: 150.     CrossRef
  • Transforaminal Epidural Injection for Far Lateral Lumbar Disc Herniations: An Alternative to Surgery or Just a Delay?
    Luay Serifoglu, Mustafa U Etli
    Cureus.2024;[Epub]     CrossRef
  • Full-Endoscopic Extraforaminal Approach for Extraforaminal Herniated Intervertebral Disc Disease: Exploring Challenging Case
    Jae Hwan Lee, Kai-Sheng Chang, Li-Wei Sun, Kuo-Tai Chen, Chien-Min Chen
    Journal of Minimally Invasive Spine Surgery and Technique.2024; 9(Suppl 1): S85.     CrossRef
  • Long-term follow-up results of surgically treated patients with foraminal and far lateral disc herniations
    Huseyin Dogu, Nuriye Guzin Ozdemir, Hakan Yilmaz, Ibrahim Burak Atci
    British Journal of Neurosurgery.2023; 37(1): 49.     CrossRef
  • Efficacy of Epidural Steroid Injections and Evaluation of Surgical and Anesthetic Approaches in Far-Lateral Disc Herniations
    Hande Gurbuz, Mehmet Secer, Aykut Gokbel
    Pain Management.2023; 13(2): 95.     CrossRef
  • A Modified Approach for Minimally Invasive Tubular Microdiscectomy for Far Lateral Disc Herniations: Docking at the Caudal Level Transverse Process
    Murray Echt, Adewale Bakare, Richard G. Fessler
    Medicina.2022; 58(5): 640.     CrossRef
  • Clinical Experience on Intertransverse Extraforaminal Approach for Far Lateral Disc Herniations
    A Gökyar, F Tonga
    Nigerian Journal of Clinical Practice.2022; 25(5): 630.     CrossRef
  • Percutaneous Endoscopic Discectomy Via a Transforaminal Approach for L5/S1 Far-Lateral Disc Herniation Assisted by Intraoperative Computed Tomography
    Bing Ran, Rong Chen, Chanchan Song, Yi Li, Jun Wei, JunMing Ye
    World Neurosurgery.2022; 166: e823.     CrossRef
  • Ein extrem lateraler Bandscheibenvorfall L4/5
    Thomas Lübbers, Rainer Baalmann, Gerd Sandvoss
    Die Wirbelsäule.2021; 05(04): 259.     CrossRef
  • The irony of the transforaminal approach
    Yong Ahn, Byung Rhae Yoo, Jong-myung Jung
    Medicine.2021; 100(40): e27412.     CrossRef
  • Comparison of post surgical results in medial and lateral lumbar spine herniated discs: Own case series experience
    Domenico Chirchiglia, Attilio Della Torre, Domenico La Torre
    Interdisciplinary Neurosurgery.2020; 22: 100748.     CrossRef
  • Minimally Invasive, Far Lateral Lumbar Microdiscectomy with Intraoperative Computed Tomography Navigational Assistance and Electrophysiological Monitoring
    Hesham Soliman, Jared Fridley, Albert Telfeian, David B. Choi, Michael Galgano, Thomas Kosztowski, Ziya L. Gokaslan, Adetokunbo A. Oyelese
    World Neurosurgery.2019; 122: e1228.     CrossRef
  • Extraforaminal Lumbar Disk Herniations Lead To Neuroplastic Changes: a Study Using Quantitative Sensory Testing
    Anja Tschugg, Sara Lener, Sebastian Hartmann, Valentin Fink, Sabrina Neururer, Matthias Wildauer, Wolfgang N. Löscher, Claudius Thome
    Muscle & Nerve.2018; 58(5): 676.     CrossRef
  • Five-year outcomes and predictive factors of transforaminal full-endoscopic lumbar discectomy
    Yong Ahn, Uhn Lee, Woo-Kyung Kim, Han Joong Keum
    Medicine.2018; 97(48): e13454.     CrossRef
  • Clinical and Radiological Characteristics of Lumbosacral Lateral Disc Herniation in Comparison With Those of Medial Disc Herniation
    Jung Hwan Lee, Sang-Ho Lee
    Medicine.2016; 95(7): e2733.     CrossRef
  • A Modified Approach of Percutaneous Endoscopic Lumbar Discectomy (PELD) for Far Lateral Disc Herniation at L5-S1 with Foot Drop
    Eun Hee Chun, Hahck Soo Park
    The Korean Journal of Pain.2016; 29(1): 57.     CrossRef
  • 15,185 View
  • 95 Download
  • 22 Crossref