CT-Diskography, Diskomanometry and MR Imaging as Predictors of the Outcome of Lumbar Percutaneous Automated Nucleotomy

Dullerud, R.; Amundsen, Tom; Lie, H. P.; Juel, Niels Gunnar; Magnæs, B.

doi:10.1177/028418519503600462

Cited by 7 publications

(1 citation statement)

References 11 publications

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“…The cases which developed discitis were among those done early in the study, denoting the significance of the surgeon's learning curve. Some authors believe that a decrease in disc height of more than 50% is a contraindication as the wand is too close to the endplates 20 26…”

Section: Discussionmentioning

confidence: 99%

Lumbar disc nucleoplasty using coblation technology: clinical outcome

Azzazi

AlMekawi

Zein

2010

J NeuroIntervent Surg

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Section: Discussionmentioning

confidence: 99%

Lumbar disc nucleoplasty using coblation technology: clinical outcome

Azzazi

AlMekawi

Zein

2010

J NeuroIntervent Surg

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Automated percutaneous lumbar discectomy: technique, indications and clinical follow-up in over 1000�patients

Bonaldi

2003

Neuroradiology

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This paper summarises my experience, over 14 years, treating over 1350 patients suffering from lumbar disc pathology, using minimally invasive intradiscal decompressive percutaneous techniques. The vast majority underwent the method introduced by Onik in 1985, referred to as "automated" since it involves a mechanical probe, working by a "suction and cutting" action for removal of the nucleus pulposus. Postoperative follow-up of at least 6 months was available for 1047 patients aged 15-92 years, who underwent this procedure up to June 2002. Results, based on a patient satisfaction, have been good in 58% of patients at 2 months and in 67.5% at 6 months; they have been particularly favourable in some subgroups such as elderly people (79.5% of excellent or good results), patients previously operated upon (78%) and those with "discogenic" low back pain (79%). Complication rates have been extremely low (less than 1%) and all complications cleared up without sequelae. In comparison with other percutaneous disc treatments, Onik's achieves the best compromise between clinical efficacy, comfort for the patient and low invasiveness.

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Five-year outcome of surgical decompression of the lumbar spine without fusion

et al. 2010

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As the average life expectancy of the population increases, surgical decompression of the lumbar spine is being performed with increasing frequency. It now constitutes the most common type of lumbar spinal surgery in older patients. The present prospective study examined the 5-year outcome of lumbar decompression surgery without fusion. The group comprised 159 patients undergoing decompression for degenerative spinal disorders who had been participants in a randomised controlled trial of post-operative rehabilitation that had shown no between-group differences at 2 years. Leg pain and back pain intensity (0-10 graphic rating scale), self-rated disability (Roland Morris), global outcome of surgery (5-point Likert scale) and re-operation rates were assessed 5 years post-operatively. Ten patients had died before the 5-year follow-up. Of the remaining 149 patients, 143 returned a 5-year follow-up (FU) questionnaire (effective return rate excluding deaths, 96%). Their mean age was 64 (SD 11) years and 92/143 (64%) were men. In the 5-year follow-up period, 34/143 patients (24%) underwent re-operation (17 further decompressions, 17 fusions and 1 intradural drainage/debridement). In patients who were not re-operated, leg pain decreased significantly (p < 0.05) from before surgery to 2 months FU, after which there was no significant change up to 5 years. Low back pain also decreased significantly by 2 months FU, but then showed a slight, but significant (p < 0.05), gradual increase of <1 point by 5-year FU. Disability decreased significantly from pre-operative to 2 months FU and showed a further significant decrease at 5 months FU. Thereafter, it remained stable up to the 5-year FU. Pain and disability scores recorded after 5 years showed a significant correlation with those at earlier follow-ups (r = 0.53-0.82; p < 0.05). Patients who were re-operated at some stage over the 5-year period showed significantly worse final outcomes for leg pain and disability (p < 0.05). In conclusion, pain and disability showed minimal change in the 5-year period after surgery, but the re-operation rate was relatively high. Re-operation resulted in worse final outcomes in terms of leg pain and disability. At the 5-year follow-up, the "average" patient experienced frequent, but relatively low levels of, pain and moderate disability. This knowledge on the long-term outcome should be incorporated into the pre-operative patient information process.

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CT-Diskography, Diskomanometry and MR Imaging as Predictors of the Outcome of Lumbar Percutaneous Automated Nucleotomy

Cited by 7 publications

References 11 publications

Lumbar disc nucleoplasty using coblation technology: clinical outcome

Lumbar disc nucleoplasty using coblation technology: clinical outcome

Automated percutaneous lumbar discectomy: technique, indications and clinical follow-up in over 1000�patients

Five-year outcome of surgical decompression of the lumbar spine without fusion

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