ABSTRACT
Lumbar and radicular pain due to HNP has been described since 1934. It is thought that the pain is caused by compression and by other local chemical mediators that are present in the area of interaction between the root and the disc.With the objective of treating patients suffering from this syndrome and with a percutaneous minimally invasive approach, we designed a mixed technique: percutaneous automated nucleotomy plus nucleolysis and periradicular infiltration with ozone.A retrospective study of 105 patients was conducted, including 60 men and 45 women with an average age of 43 years. All patients were treated with that technique between November 2006 and August 2008. Clinical follow-up of 15.2 months was provided by telephone, utilizing a modified Mac Nab scale. The results were as follows: 60% excellent, 22.8% good (82.8% success), 9.6% acceptable, 7.6% poor. From the eight patients that reported poor results, five were considered to have recurrent symptoms (4.8%), because they had initially shown a period of significant improvement post operatively. Morbidity was manifested by transient pain and muscle spasms in the post operative area (2.8%).We conclude that this new mixed technique, compared to automated percutaneous nucleotomy alone, may be more widely utilized by broadening the indications, with acceptable results.
Subject(s)
Diskectomy, Percutaneous/methods , Intervertebral Disc Chemolysis/methods , Ozone/therapeutic use , Spinal Diseases/surgery , Adult , Aged , Female , Follow-Up Studies , Humans , Lumbar Vertebrae/surgery , Magnetic Resonance Imaging , Male , Middle Aged , Pain Measurement/methods , Retrospective Studies , Spinal Diseases/pathology , Young AdultABSTRACT
This study documents the efficacy of chemonucleolysis with radiopaque gelified ethanol in the treatment of cervical and lumbar disc herniation and discogenic pain. Ten patients underwent this procedure between April 1 and June 30, 2010. Satisfactory results were obtained in 100 percent of patients. There were no adverse events reported during or post-procedure and a significant reduction in pain and analgesic intake after intradiscal injection was registered. This technique, simple and safe to perform, yielded satisfactory results; thus, it appears to be a good alternative in the treatment of herniated discs and discogenic pain.
Este estudio reporta el resultado de quimionucleolisis usando etanol gelificado radiopaco en el tratamiento de hernias discales o dolor discogénico en columna cervical y lumbar. La muestra de pacientes fue relativamente pequeña y corresponde al periodo del 1º de abril al 30 de junio de 2011. Los resultados fueron satisfactorios en el 100 por ciento de los pacientes. No hubo eventos adversos durante y luego del procedimiento. Se observó significativa reducción de analgésicos y dolor después del procedimiento. Esta técnica fue relativamente simple de realizar y segura en su aplicación mostrando buenos resultados. Promete ser una buena alternativa en el tratamiento de hernias discales o dolor discogénico.