Advertisement

Skeletal Radiology

, Volume 42, Issue 1, pp 49–53 | Cite as

CT- and fluoroscopy-guided percutaneous discectomy for lumbar radiculopathy related to disc herniation: a comparative prospective study comparing lateral to medial herniated discs

  • Nicolas AmorettiEmail author
  • Laurent Huwart
  • Pierre-Yves Marcy
  • Pauline Foti
  • Olivier Hauger
  • Pascal Boileau
Scientific Article

Abstract

Objective

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.

Results

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.

Conclusion

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.

Keywords

Percutaneous disk decompression CT guidance Spine Interventional radiology 

Notes

Conflict of interest

None of the authors received or receives commercial support or is financially involved with the device used in this study.

References

  1. 1.
    Cypress BK. Characteristics of physician visits for back symptoms: a national perspective. Am J Public Health. 1983;73:389–95.PubMedCrossRefGoogle Scholar
  2. 2.
    Ramirez LF, Thisted R. Using a national health care data base to determine surgical complications in community hospitals: lumbar discectomy as an example. Neurosurgery. 1989;25:218–25.PubMedCrossRefGoogle Scholar
  3. 3.
    Stolke D, Sollmann WP, Seifert V. Intra- and postoperative complications in lumbar disc surgery. Spine. 1989;14:56–9.PubMedCrossRefGoogle Scholar
  4. 4.
    Alo KM, Wright RE, Sutcliffe J, et al. Percutaneous lumbar discectomy: clinical response in an initial cohort of fifty consecutive patients with chronic radicular pain. Pain Pract. 2004;4:19–29.PubMedCrossRefGoogle Scholar
  5. 5.
    Erginousakis D, Filippiadis DK, Malagari A, et al. Comparative prospective randomized study comparing conservative treatment and percutaneous disk decompression for treatment of intervertebral disk herniation. Radiology. 2001;260:487–93.CrossRefGoogle Scholar
  6. 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

Copyright information

© ISS 2012

Authors and Affiliations

  • Nicolas Amoretti
    • 1
    Email author
  • Laurent Huwart
    • 1
  • Pierre-Yves Marcy
    • 1
  • Pauline Foti
    • 3
  • Olivier Hauger
    • 4
  • Pascal Boileau
    • 2
  1. 1.Department of Radiology, Hôpital archet 2Centre Hospital-Universitaire de NiceNiceFrance
  2. 2.Department of Orthopedic Surgery, Hôpital archet 2Centre Hospital-Universitaire de NiceNiceFrance
  3. 3.Department of Medical Statistics, Hôpital archet 2Centre Hospital-Universitaire de NiceNiceFrance
  4. 4.Department of Radiology, Hôpital PellegrinCentre Hospitalo-Universitaire de BordeauxBordeauxFrance

Personalised recommendations