Clinical Analysis of Automated Percutaneous Discectomy for Herniated Lumbar Disc.

Shin, Won Han; Kim, Yong Dug; Kim, Bum Tae; Choi, Soon Kwan; Byun, Bark Jang

Original Article

Journal of Korean Neurosurgical Society 1995;24(9): 1065-1073.

Won Han Shin, Yong Dug Kim, Bum Tae Kim, Soon Kwan Choi, Bark Jang Byun

Department of Neurosurgery, College of Medicine, Soonchunhyang University, Seoul, Korea.

ABSTRACT

A retrospective study of operative results was carried out in a series of 48 patients who were performed automated percutaneous discectomy for herniated lumbar disc using Nucleotome between Jan. 1990 and Jan. 1994. The operative results were analysed, and the correlation between preoperative clinicoradiological factors and postoperative clinical results were statistically assessed. The major results were as follows: 1) Of 48 patients, 37 were males and 11 were females. Mean age of the patients was 31.7 years and the highest incidence occurred in their thirties. 2) The preoperative symptoms and signs were radiating pain(100%), lumbago(94%), motor weakness(21%), and positive score in straight leg raising test(77%). Mean duration of symptoms was 33.1 months and the duration of recent aggravation was 3.7 months. 3) Operation was performed in 62 intervertebral discs, the most commonly involved level was L4-5(53%). Mean duration of follow-up was 19.1 months. 4) Clinical results on follow-up were graded excellent in 65%, good in 21%, fair 8% and poor in 6% by Cagot's classification, and the overall success rate was 85% by Onik's classification. 5) As to age distribution and the group concerning compensatory and non-compensatory, success rates were not statistically significant. 6) The causes of failure were sequestered discs in 3 cases, suspicious sequestered discs in 2 cases, combined spinal stenosis with multiple discs in 1 case and worker's compensation in 1 case. According to the above results, automated percutaneous discectomy was recommended as primary choice of relatively noninvasive surgical procedure for the herniated lumbar discs except or sequestered disc and spinal stenosis.

Key Words: Automated percutaneous discctomy; Herniated lumbar disc; MRI; Non-invasive primary choice; Sequestered disc; Spinal stenosis