Percutaneous nucleotomy in lumbar disc herniation. Patient selection and role in various treatments

Patients in percutaneous nucleotomy who met our new criteria for patient selection in 1992 showed 73% successful results. The success rate was not satisfactory in comparison with that (88%) in the open surgery through posterior approach (herniotomy), however. The purpose of this report is to re-evaluate 70 patients with follow-up more than 2 years based on imaging and clinical findings before percutaneous nucleotomy. In results, supplementary criteria such as two types of the combination of computed tomography discogram and computed tomography myelogram, continuation of the contrast medium in lateral view of discogram, and clinical findings characterized by sciatic pain were obtained to improve the success rate. Eighty-one percent of patients who met the new criteria in 1992 and the supplementary criteria were identified in the successful group. The authors believe that percutaneous nucleotomy should be considered as an independent operative procedure with results similar to open surgery, if the patient is selected strictly based on these criteria and supplementary criteria.