Clinical Results after Percutaneous Automated Lumbar Nucleotomy

Abstract

This study was carried out in order to assess the clinical results after percutaneous automated nucleotomy with regard to predictive factors for the outcome. Selection criteria included patients with predominance of low-back pain, diffuse posterior disk bulges and concomitant spinal stenosis who are not normally accepted for nucleotomy. In all, 142 patients were treated. The overall success rate after an average observation time of 21 months was 56%. The results were not influenced by whether a diffuse posterior bulge or a focal hernia had been treated or not (p=0.449). Spinal stenosis (p=0.043) and disk space narrowing exceeding 25% of the expected width (p=0.017) were associated with a poor outcome. By excluding these categories and patients with symptoms from more than one disk level, the success rate rose to 70%. With this selection, the results were equally good in patients with predominantly low-back pain compared to those with predominantly sciatica (p=0.490).

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

“…Dullerud also reported equally good results with percutaneous nucleotomy in patients with predominantly low back pain (paracentral contained herniation), as compared to those with predominantly sciatica (posterolateral contained herniation) 33 . Pressure and stress tolerances wane as discs age, however, leading to degeneration and reduced efficacy with percutaneous decompressive techniques 3,8,24 …”

“…Chymopapain can lead to fatal anaphylaxis, cartilaginous endplate damage, hemorrhage, and is dose dependent 17,30–32 . Both automated and manual nucleotomy have been difficult to confirm, 33 with one author suggesting that positive outcomes may be equivalent to spontaneous resolution of symptoms 30 . Laser discectomy may be associated with endplate injury and has enjoyed less success than chemonucleolysis when randomized 34 .…”

Cross-Cultural Adaptation of the Norwegian Versions of the Roland-Morris Disability Questionnaire and the Oswestry Disability Index

“…Furthermore, the adapted versions should be evaluated according to basic measurement properties such as reliability and validity. Despite that a number of different Norwegian versions of the RMQ and ODI have been used (19)(20)(21), the translation and cross-cultural adaptation process of these questionnaires have never been reported earlier. Furthermore, to our knowledge, there are no studies reporting the measurement properties of the RMQ or the ODI, version 2.0, used in Norwegian patients.…”