CT- and fluoroscopy-guided percutaneous discectomy for lumbar radiculopathy related to disc herniation: a comparative prospective study comparing lateral to medial herniated discs.

Abstract

OBJECTIVE:

To evaluate and compare two groups of patients with sciatica due to intervertebral disc herniation with no neurologic deficit. The groups consisted of patients with intervertebral disc herniation in a medial location (group 1) and those in a lateral location (group 2).

MATERIALS AND METHODS:

A total of 200 patients were included in the study and were followed for a minimum of 6 months. In our series, we treated 80 postero-lateral herniated discs (40% of cases), 46 postero-medial herniated discs (23%), and 74 foraminal herniated discs (37%). Level L3-L4 was treated in 30 cases (15%), L4-L5 in 98 cases (49%), and L5-S1 in 72 cases (36%). The procedure was performed under dual guidance: fluoroscopic and CT. A helical probe was activated. It penetrates the herniated disc and causes the pulpous material to be mechanically evacuated through the probe. All 200 patients were followed for a minimum of 6 months.

RESULTS:

In group 1, the patients had a mean pain score of 7.9 ± 2.5 VAS units (range 6-10 units) prior to intervention. This was reduced to 3.2 ± 2.1 VAS units (range 0-10 units) at 48 h follow-up and increased to 3.9 ± 1.2 VAS units (range 0-10 VAS units) at 1 month follow-up and further reduced to 2.7 ± 1.2 units (range 0-10 VAS units) at 6 month follow-up. In group 2, the patients had a mean pain score of 8.2 ± 3.2 VAS units (range 6-10 units) prior to intervention. This was reduced to 2.8 ± 1.5 VAS units (range 0-10 units) at 48 h follow-up and decreased to 1.5 ± 0.9 VAS units (range 0-10 units) at 1 month and further reduced to 1.1 ± 0.5 VAS units (range 0-10 units) at 6 months.

CONCLUSION:

Our study showed that results were more satisfactory for the hernia located laterally (postero-lateral, foraminal, and extra-foraminal) as compared to the hernia located posteromedially.

• Authors: Nicolas Amoretti, Laurent Huwart, Pierre-Yves Marcy, Pauline Foti, Olivier Hauger, Pascal Boileau
• Journal: Skeletal radiology (Skeletal Radiol) Vol. 42 Issue 1 Pg. 49-53 (Jan 2013) ISSN: 1432-2161 [Electronic] Germany
• PMID: 22644540 (Publication Type: Comparative Study, Journal Article)

Topics

• Adult
• Analysis of Variance
• Female
• Fluoroscopy
• Humans
• Intervertebral Disc Displacement (diagnostic imaging, surgery)
• Lumbar Vertebrae
• Male
• Middle Aged
• Pain Measurement
• Prospective Studies
• Radiculopathy (diagnostic imaging, surgery)
• Radiography, Interventional (methods)
• Sciatica (diagnostic imaging, surgery)
• Statistics, Nonparametric
• Tomography, X-Ray Computed
• Treatment Outcome