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Lumbar percutaneous discectomy. Initial experience in 28 cases.

C Faubert1, W Caspar

  • 1Neuroradiological Institute, University of Saarland, Homburg/Saar, Federal Republic of Germany.

Neuroradiology
|January 1, 1991
PubMed
Summary

Percutaneous discectomy offers a 64.3% success rate for lumbar radiculopathy due to L4/L5 disc herniation refractory to conservative treatment. While generally safe, some patients may require further surgery or experience minor complications.

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Area of Science:

  • Neurosurgery
  • Orthopedic Surgery
  • Minimally Invasive Procedures

Background:

  • Lumbar radiculopathy, particularly from L4/L5 disc herniation, often presents a challenge for conservative management.
  • Refractory cases necessitate evaluation of alternative, less invasive surgical options.

Purpose of the Study:

  • To evaluate the efficacy and safety of percutaneous discectomy for lumbar radiculopathy caused by L4/L5 disc herniation.
  • To assess clinical outcomes, functional status, and professional reintegration post-procedure.

Main Methods:

  • A cohort of 28 patients with refractory lumbar L5 radiculopathy and verified L4/L5 central or mediolateral disc herniation underwent percutaneous discectomy.
  • Radiological confirmation utilized spinal CT, myelography, myelo-CT, and MRI.

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  • Short-term follow-up (≥2 months) assessed clinical and functional status, including professional reintegration.

    • Main Results:

    • A satisfactory outcome was achieved in 64.3% (18/28) of patients.
    • A failure rate of 32.1% (10/28) was observed, with 28.6% (8/28) requiring subsequent open surgery.
    • One case of sequestered cranial prolapse and one instance of sequestered extraforaminal herniation were noted post-procedure. Minor complications included transient bleeding and local pain.

    Conclusions:

    • Percutaneous discectomy demonstrates a favorable short-term outcome for select patients with refractory lumbar radiculopathy due to L4/L5 disc herniation.
    • The procedure is associated with a low rate of major complications, though further surgical intervention may be necessary in some cases.