Preliminary assessment of the results of percutaneous nucleoplasty in the treatment of the lumbar degenerative disc disease
Keywords:
nucleoplasty, coblation, percutaneous disc decompression, disc herniationAbstract
Aim: The aim of this research is to determine the effectiveness of mechanical lumbar disc decompression by means of nucleoplasty.
Clinical material: The group of 30 patients with disc herniation in the lumbar spine was examined. The clinical effect of nucleoplasty was assessed by changes in : (1) the quality of life (Oswestry’s questionnaire), (2) pain intensity (VAS scale) in the spine and sciatica, and the reduction in the amount of analgesics taken by patients. The assessment was performed at check-ups in the period from 3 to 12 months after the procedure. The average age of patients in the group was 41,5 years.
Method: Nucleoplasty was performed with local anaesthesia. Discography of the target disc always preceded coblation in order to confirm that the hernia is contained (non-contained hernia with ruptured annulus fibrosus is a contradiction to the procedure). All patients had six coblation channels created during nucleoplasty. 29 patients had one adjacent disc treated, and one patient had two to treat. In total 31 discs were treated in the series.
Results: The average preoperative VAS was 6,43 and it was reduced to about 3,73 after treatment. The average preoperative Oswestry score was 22 and it was reduced to 14,97 in the last check-up. The analgesics were totally put away or reduced in 15 patients, who took the pills (71%). General improvement was noted in 22 patients. There was one complication connected with the procedure – discitis.
Conclusions: The research confirmed that the differences between pre-op and post-op Oswestry, VAS and the amount of analgesic were statistically significant at the level p<0,05.
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