Akademik Veri Yönetim Sistemi
TURKIYE KLINIKLERI TIP BILIMLERI DERGISI, cilt.30, sa.1, ss.201-206, 2010 (SCI-Expanded)
Objective: Percutaneous decompression approach is associated with potential complications, limitations and poor outcome. Nucleotomy is used for suction of disc material. Nucleoplasty (NP) procedure utilizes coblation technology which allows for decompression of the disc using radiofrequency energy. The aim of study is to evaluate the effectiveness of NP versus automatic percutaneous lumbar discectomy (APLD) in pain and disability scores for decompression of contained herniated discs. Material and Methods: A prospective, randomized study was conducted on 189 consecutive patients with complaints of low back pain with or without leg pain secondary to a contained lumbar herniated disc. Patients were ASA I-II physical status, and aged between 19-55 years. There were 96 patients in Group NP (67 females, 29 males), and 93 patients in Group APLD (66 females, 29 males). Control examinations were performed at 1st, 6th, 12th and 18th months and pain scores and Oswestry Disability Questionnaires (ODQ) were evaluated during controls. Results: The pre-procedure and post-procedure visual analog scale (VAS) scores in group APLD and NP were 6.95, 2.44 and 7.14, 2.51 respectively. The VAS scores decreased in two groups and the difference between pre-procedure and post-procedure VAS scores were statistically significant (p<0.05). The reduction in VAS score continued in control examinations. The pre-procedure and post-procedure ODQ scores in group APLD and NP were 41.79, 22.81 and 41.48, 22.82 respectively. These differences between pre-procedure and post-procedure scores were also statistically significant (p<0.05). The reduction in ODQ scores continued in control examinations. In the APLD group, there was a statistically significant prolongation in time of procedure. No complications were observed in both groups. Conclusion: The results of this study demonstrated a statistically significant improvement in VAS and Oswestry index scores at 1st, 6th, 12th and 18th months in both techniques. Because NP is a short and effective technique. NP should be the first choice for the treatment of symptoms associated with contained lumbar herniated discs.