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A Mobile Outside-in Technique of Transforaminal Lumbar Endoscopy for Lumbar Disc Herniations
Published on: August 7, 2018
Prognostic Factors for Successful Percutaneous Disc Decompression Using the Navigable Device L'DISQ™ in Patients with
Ji Yeong Kim1, Ku Sang Lee2, Sang Min Jung2
1epartment of Anesthesiology and Pain Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
Background:
The navigable percutaneous disc decompression (PDD) device L'DISQ is an effective and safe option for the treatment of lumbar discogenic pain. However, few studies have evaluated the prognostic factors of successful PDD using this device.
Objective:
This study aimed to evaluate the prognostic factors associated with the successful outcome of PDD using the L'DISQ for treating lumbar discogenic pain by following up patients before and one, 2, 3, and 6 months after the procedure.
Study Design:
Retrospective cohort study.
Setting:
Tertiary university hospital.
Methods:
A successful outcome was defined as a >= 50% reduction in the numeric rating scale scores for pain and a >= 40% reduction in the Oswestry Disability Index scores at 6 months after the procedure. Clinical parameters and patient demographics, including pain duration, history of surgery, number of treatment levels, and the radiographic findings of lumbar magnetic resonance imaging (MRI), were also examined.
Results:
Of the 106 patients included, 80 (75.5%) had successful outcomes at 6 months. Multivariable logistic regression analysis revealed that the presence of high-intensity zones (HIZs) (P = 0.016) was an independent positive predictor of successful PDD outcomes; conversely, migration of the herniated disc (P = 0.017) and bilaterally herniated discs (P = 0.001) were negative predictors.
Limitations:
The limitations of this study were its retrospective design, absence of a control group, and difficulty in predicting the effect when multiple levels were involved because of the use of MRI characteristics of the disc as a predictor.
Conclusions:
The presence of HIZs, the absence of migration of herniated discs, and the presence of unilaterally herniated discs are positive predictors of successful outcomes of PDD using the L'DISQ.
