Efficacy of Single Level Versus Double Levels Surgery of Percutaneous Disc Nucleoplasty (PDN) Approach in Treating Lumbar Disc Herniation

Abstract

Background Although percutaneous disc nucleoplasty (PDN) has been widely applied in treating lumbar disc herniation (LDH) in recent years, the efficacy of surgical levels for PDN on LDH has been reported in limited studies. This study aimed to explore and compare the efficacy of surgical levels (single level vs double level) of PDN in treating LDH. Material/Methods All patients diagnosed with LDH from January 2012 to December 2014 in our hospital who underwent PDN were included in this study. Patients were divided into a single-level group and double-level group based on the number of discs/surgical treatment levels. The improvement of visual analog scale (VAS) score, patient satisfaction, and reoperation occurrence were compared between the 2 groups. Results Of 105 total patients, 75 patients were treated with single-level treatment and 30 patients with double-level treatment. VAS for leg pain and patient satisfaction scores in the double-level group were worse than those in the single-level group at 6 months after surgery ( P <0.05). Among all 105 patients, the incidence of reoperation was 11.4%. Also, there was a marked difference in reoperation occurrence at 6 months after surgery between the single-level (6.7%) and double-level (23.3%) groups; however, the difference was not statistically significant ( P =0.05). Conclusions PDN is a safe and minimal-invasive approach, which could effectively treat LDH. The number of surgical levels might be an important factor influencing the efficacy of PND. Caution should be exercised to strictly follow the clinical indications for nucleoplasty.

The assessment of the validity, safety, and utility of ChatGPT for patients with herniated lumbar disc: A preliminary study

“…Furthermore, ChatGPT reported a list of medications for HLD but did not include opioids, serotonin and norepinephrine reuptake inhibitors, and anticonvulsants, such as topiratmate, pregabalin, or gabapentin. [15][16][17] In addition, we believe that percutaneous epidural neuroplasty, [18] nucleoplasty, [19] or pulsed radiofrequency neuromodulation [20] could be considered as alternative procedures for treating HLD when steroid injections are ineffective. The validity, safety, and utility of Question 8 (How many times should epidural steroid injections be administered to patients with HLD?)…”

Machine Learning Assisting the Prediction of Clinical Outcomes following Nucleoplasty for Lumbar Degenerative Disc Disease

“…(2) physicians' subjective reading of images, e.g., of the positive hyperintensity zone, black disc, and Modic changes of the end plates; and (3) invasive challenge discography results [30]. Furthermore, most previous studies have only demonstrated the efficacy of LNP, but few have discussed the outcome prediction or prognostic factors [31][32][33]. With AI-assisted assessments based on patients' general data and objective analysis of image radiomic features, we can not only prevent human errors but also reduce the invasiveness of diagnostic tools such as discography.…”