CT- and fluoroscopy-guided percutaneous discectomy for lumbar radiculopathy related to disc herniation: a comparative prospective study comparing lateral to medial herniated discs
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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.
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.
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.
KeywordsPercutaneous disk decompression CT guidance Spine Interventional radiology
Conflict of interest
None of the authors received or receives commercial support or is financially involved with the device used in this study.
- 6.Amoretti N, Hauger O, Marcy PY et al. Percutaneous discectomy on lumbar radiculopathy related to disk herniation: why under CT guidance? An open study of 100 consecutive patients. Eur J Radiol 81:1259–1264Google Scholar