[Results of percutaneous discectomy in the management of lumbar disc herniation].

Abstract

INTRODUCTION:

Percutaneous discectomy is a disc decompression technique approved by the FDA that is useful to improve pain caused by a herniated disc. However, its practice is under discussion because the benefits of the technique are controversial.

OBJECTIVES:

To describe the clinical course of patients with low lumbar disc herniation (L4-L5, L5-S1) treated by percutaneous surgery within one year of surgery and prove that it is a useful surgical option for the relief of symptoms caused by this pathological entity.

MATERIAL AND METHODS:

Cohort study; the clinical course of 21 patients with lumbar disc herniation treated with percutaneous discectomy manually during March 2011-November 2013, is presented. The evaluation was made before surgery and at four, 30, 180 and 365 days after surgery by numerical pain scale (NPS), Oswestry (IDO) and MacNab criteria. We used nonparametric inferential statistics (Wilcoxon) for differences in proportions.

RESULTS:

n = 21, six (28.57%) men, 15 (71.42%) women; average age: 37.95, (14-56) ± 10.60 years; the most affected vertebral level was L4-L5 in 57.14% of the patients; the NPS preoperative average was 7.75 (5-9) ± 1.12; at 365 days: average 2.14 (0-7) ± 2.37. The IDO preoperative average was 37% (28-40%) ± 3.06, and at 365 days: 9.52% (0-40%) ± 13.92. The prognosis (IDO) in the presurgical was good to zero (0%) patients and in 15 (71.42%) at 365 days, regular in five (23.80%) and poor in one (4.78%) (p = 0.00, CI 95% 0.00 to 0.13, Wilcoxon); according to MacNab criteria, in 15 (71.42%) patients were excellent and good, poor in four (19.04%) and bad in two (9.52%) (p = 0.00).

CONCLUSIONS:

Percutaneous discectomy provides good results for the treatment of lumbar disc herniation (L4-L5, L5-S1) at 365 days after surgery.

• Authors: P G Lima-Ramírez, A J Montiel-Jarquín, R G Barragán-Hervella, M A Sánchez-Durán, A Ochoa-Neri, J Loria-Castellanos, C Vázquez-Rodríguez, A Villatoro-Martínez, J J Castillo-Pérez
• Journal: Acta ortopedica mexicana (Acta Ortop Mex) 2016 Jul-Aug Vol. 30 Issue 4 Pg. 170-175 ISSN: 2306-4102 [Print] Mexico
• Vernacular Title: Resultados de la nucleotomía percutánea en el manejo de la hernia discal lumbar.
• PMID: 28267905 (Publication Type: Journal Article)

Topics

• Adult
• Cohort Studies
• Diskectomy, Percutaneous
• Female
• Humans
• Intervertebral Disc Displacement (therapy)
• Lumbar Vertebrae
• Male
• Middle Aged
• Treatment Outcome