Minimaly Invasive Spinal Surgery: Cinical analysis of Chemonucleolysis & Percutaneous Automated Lumbar Discectomy

The authors retrospectively analized the radiographs and medical records of 135 consecutive patients who underwent minimaly invasive spinal surgery from January, 1990 to December, 1994 at our institution. Among these, 72 patients have had chemonucleolysis and others percutaneous automated lumbar discectomy(PALD). The success rate was similar in both groups, ie, 75% in chemonucleolysis and 74.6% in PALD by Macnab's criteria. The higher success rate could be obtained in 1) younger age below 30, 2) predominant sciatica than lower back pain, 3) eccentric bulged disc with minimal degeneration, 4) abscent or minimal neurologic deficits. In conclusion, provided patients are carefully screened, minimal invasive spinal surgery is more preferable over conventional surgery, providing a safe and effective therapeutic alternative to many patients suffering from herniated lumbar disc.

Percutaneous Automated Discectomy using Nucleotome in Lumbar Disc Herniations

The authors performed 19 cases of percutaneous automated discectomy using Nucleotome between Feb, 1988 and Jan, 1993. The mean age was 33 years ranging from 20 to 56 years. Eleven of the patients were men and eight were women. One level nucleotomy was done in 14 cases, two level in 4 cases and three level in 1 cases. Overall success rate was 63%. No intraoperative and postoperative complications occurred except transient back pain in 3 cases.

Chemonucleolysis Versus Percutaneous Automated Discectomy Using Nucleotome

Authors reviewed the radiographs and medical records of 85 consecutive patients who underwent chemonucleolysis and percutaneous automated discectomy between May, 1986 and Feb. 1988 at the Dept. of Neurosurgery, Presbyterian Medical Center, Chon-ju, Korea. Among 85 consecutive patients, 48 patients underwent Chemonucleolysis and others underwent PAD using nucleotome. The results showed relatively low success rate of 60.3% in chemonucleolysis and 62.2% in PAD. However in PAD using nucleotome, the favorable selection criteria to define the higher successful rate(70-87.5%) included; 1) in young age group under 30. 2) in the group of no motor and sensory deficits. 3) in spine CT findings, which showed mild disc protrusion and no focal central disc bulging pattern. The better results will be obtained when the careful selection of patients is done and operated technique is more developed.