[Automated percutaneous nucleotomy. Results in 50 patients]

Automated percutaneous discectomy was introduced by Onik et al. in 1985 for the treatment of lumbar disk herniation. Success rates have ranged from 42% to 86%. We evaluated efficacy and looked for factors with a bearing on outcome in a retrospective study of 50 patients. Patients who did not have subsequent surgery were evaluated at least six months after the procedure, using the criteria developed by Mac Nab and by Stauffer and Coventry. The procedure was successful in 31 patients (62%) and failed in 19 (38%). Thirteen patients with failed automated percutaneous discectomy required surgery. Severe disk degeneration was significantly predictive of treatment failure. Lumbar spinal stenosis was also associated with lower success rates. Two patients developed infectious discitis after the procedure. Automated percutaneous discectomy may be less satisfactory than nucleolysis. Further studies are needed to determine the role and efficacy of this method for the treatment of lumbar disk herniation.