Percutaneus nucleotomy procedures in lumbar spinal disc prolapse.

Area of Science:

• Neurosurgery
• Minimally Invasive Spine Surgery

Background:

• Open spinal surgery complications, like post-discotomy syndrome, spurred development of less invasive techniques.
• Lumbar disc prolapses are a primary target for these advanced surgical approaches.

Purpose of the Study:

• To review the efficacy and application of percutaneous nucleotomy for lumbar disc disorders.
• To compare percutaneous nucleotomy with other minimally invasive and traditional surgical methods.

Main Methods:

• Review of various percutaneous nucleotomy techniques developed since the 1970s, including mechanical, automated, laser, and endoscopic approaches.
• Analysis of clinical results from studies with varying methodologies, noting the scarcity of prospective randomized trials.

Main Results:

• Reported clinical success rates for percutaneous nucleotomy range widely (30% to nearly 100%).
• Many studies are retrospective or lack rigorous scientific design, impacting result reliability.
• Prospective randomized studies comparing percutaneous nucleotomy to conservative or other surgical treatments are limited.

Conclusions:

• Percutaneous nucleotomy procedures demonstrate variable success rates and are most effective when applied to carefully selected lumbar disc disorder cases.
• Strict adherence to indication criteria is crucial for achieving favorable outcomes.
• Current evidence suggests percutaneous nucleotomy should be reserved for a limited number of suitable cases when compared to endoscopic and microsurgical alternatives.