Percutaneous Lumbar Discectomy: Clinical Response in an Initial Cohort of Fifty Consecutive Patients With Chronic Radicular Pain

Alò, Kenneth M.; Wright, Robert E.; Sutcliffe, J. C.; Brandt, Scott

doi:10.1111/j.1533-2500.2004.04003.x

Cited by 59 publications

(53 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In his study, Alo used a Dekompressor 1.5 mm percutaneous discectomy probe to mechanically debulk the disc material, allowing for a reduction in intradiscal pressure. Although Alo et al used a different technology, they achieved the same goal as we did in our study using nucleoplasty 29. The mechanisms underlying the successes of both procedures are postulated to be related to disc remodeling, which results in volume reduction with a subsequent decrease in intradiscal pressure and a concomitant reduction in release of inflammatory mediators 30–32…”

Section: Discussionsupporting

confidence: 55%

Lumbar disc nucleoplasty using coblation technology: clinical outcome

Azzazi

AlMekawi

Zein

2010

J NeuroIntervent Surg

View full text Add to dashboard Cite

show abstract

Section: Discussionsupporting

confidence: 55%

Lumbar disc nucleoplasty using coblation technology: clinical outcome

Azzazi

AlMekawi

Zein

2010

J NeuroIntervent Surg

View full text Add to dashboard Cite

show abstract

“…The fast-spinning inner cannula tip can aspirate the disc material into the tissuecollecting chamber and decrease the pressure inside the disc. 181 No study has yet reported whether this DeKompressor technique can obtain live disc cells because fastspinning inner cannula can generate heat and destroy disc cells. If the disc cell samples obtained through the DeKompressor can be alive, it may prove to be a useful tool for future research on disc cell culture, expansion, functional evaluation for matrix formation, and possible autologous transplantation to prevent and treat the discogenic pain due to disc degeneration and IDD.…”

Section: Cell Transplantationmentioning

confidence: 99%

Diagnosis and Minimally Invasive Treatment of Lumbar Discogenic Pain – A Review of the Literature

Zhou

Abdi

2006

The Clinical Journal of Pain

View full text Add to dashboard Cite

Diagnosis and treatment of lumbar discogenic pain due to internal disc disruption (IDD) remains a challenge. It accounts for 39% of patients with low back pain. The mechanism of discogenic pain remains unclear and its clinical presentation is atypical. Magnetic resonance imaging (MRI) can find high-intensity zone as an indirect indication of IDD. However, relative low sensitivity (26.7% to 59%) and high false-positive (24%) and false-negative (38%) rates reduce the value of MRI in screening for the existence of painful IDD. Provocative discography can provide unique information about the pain source and the morphology of the disc. It may also provide information for selecting appropriate treatment for the painful annular tear. Adjunctive therapies, including nonsteroidal anti-inflammatory drugs, physical therapy, rehabilitation, antidepressants, antiepileptics, and acupuncture, have been used for low back pain. The value of these treatments for discogenic pain is yet to be established. Intradiscal steroid injection has not been proved to provide long-term benefits. Intradiscal electrothermal therapy may offer some pain relief for a group of well-selected patients. No benefits have been found for the intradiscal radiofrequency thermocoagulation. A block in the ramus communicans may interfere with the transition of painful information from the discs to the central nervous system. Disc cell transplantation is in the experimental stage. It has the potential to become a useful tool for the prevention and treatment of discogenic pain. Minimally invasive treatments provide alternatives for discogenic pain with the appeal of cost-effectiveness and, possibly, less long-term side effects. However, the value of most of these therapies is yet to be established. More basic science and clinical studies are needed to improve the clinical efficacy of minimally invasive treatments.

show abstract

“…This causes ''disc decompression'', reducing intradiscal pressure, and theoretically redistributing and alleviating the internal forces which cause irritation of the neighboring nerve root [1,8,39,48,53]. This is posited to downregulate local inflammatory mediators, reduce disc size, and initiate the healing process, all contributing to a reduction in discogenic pain [13].…”

Section: Introductionmentioning

confidence: 99%

Plasma disc decompression for contained cervical disc herniation: a randomized, controlled trial

Cesaroni

Nardi

2009

Eur Spine J

View full text Add to dashboard Cite

Prospective case series studies have shown that plasma disc decompression (PDD) using the COBLATION SpineWand device (ArthroCare Corporation, Austin, TX) is effective for decompressing the disc nucleus in symptomatic contained cervical disc herniations. This prospective, randomized controlled clinical trial was conducted to evaluate the clinical outcomes of percutaneous PDD as compared to conservative care (CC) through 1 year. Patients (n = 115) had neck/arm pain [50 on the visual analog scale (VAS) pain scale and had failed at least 30 days of failed CC. Patients were randomly assigned to receive either PDD (n = 62) or CC (n = 58). Clinical outcome was determined by VAS pain score, neck disability index (NDI) score, and SF-36 health survey, collected at 6 weeks, 3 months, 6 months, and 1 year. The PDD group had significantly lower VAS pain scores at all follow-up time points (PDD vs. CC: 6 weeks, -46.87 ± 2.71 vs. -15.26 ± 1.97; 3 months, -53.16 ± 2.74 vs. -30.45 ± 2.59; 6 months, -56.22 ± 2.63 vs. -40.26 ± 2.56; 1 year, -65.73 ± 2.24 vs. -36.45 ± 2.86; GEE, P \ 0.0001). PDD patients also had significant NDI score improvement over baseline when compared to CC patients at the 6 weeks (PDD vs. CC: -9.15 ± 1.06 vs. -4.61 ± 0.53, P \ 0.0001) and 1 year (PDD vs. CC: -16.70 ± 0.29 vs. -12.40 ± 1.26, P = 0.005) follow-ups. PDD patients showed statistically significant improvement over baseline in SF-36 physical component summary scores when compared to CC patients at 6 weeks and 1 year (PDD vs. CC: 8.86 ? 8.04 vs. 4.24 ± 3.79, P = 0.0004; 17.64 ± 10.37 vs. 10.50 ± 10.6, P = 0.0003, respectively). In patients who had neck/arm pain due to a contained cervical disc herniation, PDD was associated with significantly better clinical outcomes than a CC regimen. At 1 year, CC patients appeared to suffer a ''relapse, showing signs of decline in most measurements, whereas PDD patients showed continued stable improvement.

show abstract

Percutaneous Lumbar Discectomy: Clinical Response in an Initial Cohort of Fifty Consecutive Patients With Chronic Radicular Pain

Abstract: STUDY OBJECTIVEThis paper reports on response to percutaneous discectomy in the initial cohort of 50 patients treated with the Dekompressor® 1.5 mm percutaneous lumbar discectomy probe at a 6-month follow-up.

Cited by 59 publications

References 39 publications

Lumbar disc nucleoplasty using coblation technology: clinical outcome

Lumbar disc nucleoplasty using coblation technology: clinical outcome

Diagnosis and Minimally Invasive Treatment of Lumbar Discogenic Pain – A Review of the Literature

Plasma disc decompression for contained cervical disc herniation: a randomized, controlled trial

Contact Info

Product

Resources

About