Removal of lower back pain through PEN technique

Mariecar Jara-Puyod, Senior Reporter

A minimally invasive procedure to relieve persistent agonising lower back pain has been seen to earn a 95 per cent high satisfactory rating among UAE residents and even visitors in the country for medical tourism.

The procedure is called PEN, the acronym for Percutaneous Epidural Neuroplasty, said to be the “most commonly done spinal procedure in Korea because it is not a conventional open surgery.

In an email interview with Himchan-UHS (University Hospital Sharjah) Joint and Spine Centre consultant spine surgeon Dr Dae Won Cho said PEN takes only up to 15 minutes to complete wherein a “one millimeter thin catheter is inserted to inject medication into the area causing the pain.”

“The area will then be irrigated with saline (a medical solution of sodium chloride in water) and anti-inflammatory medication is injected right into the spot alleviating the pain,” he also said.

With the 15 minute PEN comes the maximum two hours rest at the recovery room-in the case of the UHS-at its new Post Recovery Care Unit (PRCU)-dedicated to day surgery patients.

PRCU records revealed that of the 86 UAE and two visiting patients, 84 were “highly satisfied” of the PEN.

Cho, with 14 years of experience in spine surgeries, including minimally invasive spine surgeries, classified PEN as “the best option” for all lower back pain sufferers-young and old, whether they have yet to undergo treatment, already into it, the undecided and the unsuitable-for “without having to do with surgery, PEN reduces pain by more than 80 per cent. Spine diseases are mostly complex that a high level of anatomical understanding is required for the surgeons to maximise the effects of PEN.”

He said sufferers normally un-welcome surgeries: “The decision of having (lower back pain) surgery tends to be more difficult for young herniated disc patients or geriatric patients. They often refuse to have it when required or they simply cannot because of the co-morbidity. (But), patients in pain even after surgeries can also have this procedure (PEN). There are no limitations unless if inflammatory diseases were present or excessive bleeding is expected.”

Referring to a medical journal, Cho further explained: “While the simultaneous presence of medical problems between each vertebra is easily found in many patients, a single PEN procedure brings significant pain reduction in large areas. The use of a catheter, especially, can relieve pressure in the nerve of multi-level spinal stenosis (abnormal narrowing of the spinal canal, the signs and symptoms of which are loss of bladder and bowel control as well as sexual dysfunction) by physically creating some space.”