Early course and long-term follow-up after automated percutaneous lumbar discectomy

In this prospective study, the clinical outcome in the early course as well as the long-term results were analyzed after automated percutaneous lumbar discectomy (APLD). Thirty consecutive patients are included, all with a contained lumbar disc herniation on magnetic resonance imaging. There was a significant reduction in the sciatic pain and straight leg raising (SLR) test postoperatively at all the different measurements in the early course except for the sciatic pain at 2 weeks. On the same occasions, there was no change in the back pain or the Oswestry score. Ten patients needed subsequent open surgery. For the remaining patients, the long-term result showed a significant and unchanged improvement in the sciatic pain and SLR. In addition, the Oswestry score had now significantly improved. The failure rate of APLD turned out to be unacceptably high in this study, because 38% of the patients needed subsequent open surgery. However, an early satisfactory course also seemed to imply a beneficial long-term prognosis.