Automated percutaneous nucleotomy--initial experience in twenty-five cases of contained lumbar disc herniation

The posterolateral percutaneous approach using the automated nucleotome system has been used to treat twenty-five patients presenting with lumbar radiculopathy refractory to conservative care. The procedures were performed on an outpatient basis and under local anaesthesia and sedation. The patients were either worked up with the MRI, (Magnetic Resonance Imaging) or intra-thecal enhanced CT scan and/or lumbar myelography. All the patients were shown to have a contained central or lateral disc herniation that correlated well with the clinical findings. The overall results within a short-term follow-up period (mean of six months) were comparable to those obtained with standard lumbar discectomy. A low postoperative morbidity was associated with this procedure and no significant intraoperative complications have occurred. The indications as well as the pitfalls and potential complications of this surgical technique are emphasized in this report. This preliminary study suggests that in carefully selected patients and in experienced hands this procedure offers a viable alternative to conventional discectomy.