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Percutaneous nucleotomy with CT and fluoroscopic guidance.
R M Seibel1, D H Grönemeyer, R A Sörensen
1Institute of Diagnostic and Interventional Radiology, University Witten/Herdeck, Mulheim a.d. Ruhr, Germany.
Journal of Vascular and Interventional Radiology : JVIR
|August 1, 1992
Summary
Automated percutaneous diskectomy using CT and fluoroscopy safely treated degenerative disc disease in 110 patients. This minimally invasive procedure offered significant symptom relief for most, with few complications.
Area of Science:
- Neurosurgery
- Minimally Invasive Procedures
- Radiology
Background:
- Degenerative intervertebral disc disease often causes persistent neurologic symptoms.
- Conservative therapies are frequently unsuccessful for these patients.
- Percutaneous nucleotomy (PNT) offers a minimally invasive treatment option.
Purpose of the Study:
- To evaluate the safety and efficacy of automated percutaneous diskectomy (APD) guided by computed tomography (CT) and fluoroscopy.
- To assess clinical outcomes in patients with degenerative disc disease who failed conservative treatment.
Main Methods:
- APD was performed on 110 patients with neurologic symptoms and single-segment disc changes.
- Treatment involved local anesthesia and nucleotome use.
- Exclusion criteria included uncontained disc fragments, spinal stenosis, and facet joint disease.
Main Results:
- 82% of patients achieved complete remission of neurologic symptoms.
- 92% showed negative or improved Lasègue sign.
- 18% required further intervention, with 11% undergoing surgical nucleotomy.
- No serious complications occurred, except for one case of spondylodiskitis.
Conclusions:
- CT- and fluoroscopic-guided APD is a safe procedure with good clinical outcomes for selected patients.
- While CT guidance increases overall procedure time, it may facilitate future outpatient treatment.
- APD provides an effective alternative for patients with degenerative disc disease unresponsive to conservative management.
