Plasma disc decompression compared to physiotherapy for symptomatic contained lumbar disc herniation: A prospective...

Area of Science:

• Orthopedics
• Neurosurgery
• Pain Management

Background:

• Lumbar disc herniation often causes radicular pain.
• Standard physiotherapy is a common treatment approach.
• Evaluating alternative interventions like PDD is crucial.

Purpose of the Study:

• To compare clinical outcomes of percutaneous discectomy (PDD) versus standard physiotherapy.
• To identify patient characteristics that predict successful PDD outcomes.

Main Methods:

• 177 patients with single-level lumbar disc herniation and radicular pain were randomized.
• 89 patients received PDD, and 88 received standard physiotherapy.
• Outcomes were assessed at 12 months using VAS, Oswestry Disability Index, and SF-36.

Main Results:

• PDD group showed significantly greater reduction in leg pain and disability scores (VAS, ODI, SF-36) compared to physiotherapy (p<0.001).
• Subset analysis revealed better PDD outcomes in younger patients, those with shorter radiculopathy duration, males, and lower BMI.
• Subacute pain patients reported superior outcomes with PDD than chronic pain patients.

Conclusions:

• PDD demonstrates superior efficacy over standard physiotherapy for select patients with lumbar disc herniation.
• Optimal PDD candidates are younger, have shorter pain duration, and a favorable body habitus.
• Patient selection is key to maximizing PDD treatment success.