Article

Percutaneous lumbar disc decompression.

Pain Diagnostics Associates, Niagara, Wisconsin 54151, USA.
Pain physician (Impact Factor: 4.77). 05/2006; 9(2):139-46.
Source: PubMed

ABSTRACT Chronic low back pain is a major social, economic, and healthcare issue in the United States. Various techniques are utilized in managing discogenic pain, with or without disc herniation. Percutaneous techniques are rapidly replacing traditional open surgery in operations requiring discectomy, decompression, and fusion. The percutaneous access to the disc was first used in the 1950s to biopsy the disc with needles. Percutaneous access to the disc using endoscopic techniques was developed in the 1970s. Technical advances in the use of intradiscal therapies led to the development of intradiscal electrothermal annuloplasty (IDET), DISC Nucleoplasty, and DeKompressor, along with laser-assisted, endoscopic, and Nucleotome disc decompressions. The indications for percutaneous lumbar disc decompression include low back and lower extremity pain caused by a symptomatic disc. Internal disc disruptions and disc herniations are common causes of low back and/or lower extremity pain which may become chronic, if not diagnosed and treated. Annular tears lead to migration of the nuclear material and deranged internal architecture. In the chronically damaged intervertebral disc, leakage of nuclear material from annular tears can initiate, promote, and continue the inflammatory process and delay or stop recovery of vital remaining intradiscal tissue. The most often stated goal of central nuclear decompression is to lower the pressure in the nucleus and to allow room for the herniated fragment to implode inward. Provocative discography prior to percutaneous lumbar disc decompression is recommended. Percutaneous disc decompression may result in a small number of complications but occasionally, these could be serious.

Full-text

Available from: Richard Derby, May 07, 2015
0 Followers
 · 
143 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: We set out to assess the efficacy of radiofrequency-induced intradiscal nucleoplasty in reducing pain in symptomatic patients with MRI-defined lumbar disc herniation and their satisfaction with the procedure. We compared the patients' pain intensity and severity of disability scores before and after undergoing the procedure in a retrospective questionnaire. These patients reported statistically significant reduction of pain intensity and disability level after the procedure. We conclude that radiofrequencyinduced intradiscal nucleoplasty is an acceptable alternative minimally invasive procedure in relieving the symptoms of patients with lumbar disc herniation. Radiofrequency-induced intradiscal nucleoplasty, coblation therapy, percutaneous lumbar disc decompression, intervertebral disc herniation, low back pain.
    07/2013; 7(2):18-20. DOI:10.5704/MOJ.1307.009
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Clavicle fracture is commonly treated conservatively. However uncommon complication can arise causing impingement. We report a patient who sustained distal clavicle fracture and was treated conservatively. However he developed persistent shoulder pain that affected his daily life. Shoulder impingement was diagnosed and arthroscopic subacromioclavicular decompression was done. Following early physiotherapy the early recovery was good with full range of motion of the shoulder. Clavicle fracture, shoulder impingement, arthroscopic subacromioclavicular decompression.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: A prospective observational study. To evaluate the role of nucleoplasty in the management of discogenic axial back pain; to determine the influence of concordant pain during provocative discography, annular tear and loss of disc height on the outcome of nucleoplasty. The role of nucleoplasty in the management of radicular leg pain due to disc herniation is known. However, the data regarding its role in the management of discogenic axial back pain is scarce. A prospective evaluation of 30 patients with discogenic axial back pain undergoing nucleoplasty was performed. Pain, functional disability and quality of life were assessed using the 100 mm visual analogue scale (VAS), Oswestry Disability Index (ODI) and Short Form-36 (SF-36), respectively. The mean reduction in VAS was 31.03 and 29.03; mean reduction in ODI was 24.53 and 20.60; and mean increment in SF-36 was 13.58 and 12.30, at 6 months and at 12 months, respectively. The differences were statistically significant (p <0.05). Concordant pain during provocative discography, annular tear and loss of disc height did not affect a clinically significant improvement in any of the three outcomes (p =0.882, 0.213, and 0.170; respectively). Nucleoplasty produced statistically significant improvements in pain, functional disability and quality of life in patients with discogenic low back pain at 6 months and at 12 months. Concordant pain during provocative discography, annular tear and loss of disc height did not influence any of the outcomes after nucleoplasty in patients with discogenic axial back pain.
    Asian spine journal 12/2013; 7(4):314-21. DOI:10.4184/asj.2013.7.4.314