Treatment of herniated lumbar disc by percutaneous nucleotomy with aspiration. Preliminary results in 70 cases

Seventy patients suffering from lumbar pain with sciatica, radiculalgia or lumbodynia were reviewed at least 3 months after automated percutaneous nucleotomy (Nucleotome). There were 26 women and 44 men, aged from 19 to 72 years. Results were highly satisfactory in 39 patients (56.5%). Among these, 10 had lumbar pain of discal origin, 15 had pure radiculalgia and 14 had lumbar pain and radiculalgia. Incomplete improvement requiring medical treatment was obtained in 11 patients (15.5%). The procedure was unsuccessful in 20 patients (28.5%) with persistence or worsening of the initial symptoms; 5 of them subsequently underwent chemonucleolysis with 4 good medium-term results and 1 failure. These preliminary results show that percutaneous nucleotomy seems to be effective in lumbar pain of discal origin, with a 66.5% success rate. In patients with pure radiculalgia or lumbar pain cum radiculalgia the results are less impressive, with a success rate of about 50%. However, this well-tolerated technique may be used as first-line treatment of herniated discs when the discs are small, subligamentous and non migrated.