| A Combined Procedure of Automated Percutaneous Nucleotomy and Low-Dose Chemonucleolysis for Herniated Lumbar Disc Patients |
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Won-Bae Seung, M.D., Byung-Chan Jeon, M.D., Hyung-Keun Lee, M.D. and Keun-Sung Song, M.D.1 |
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Department of Neurosurgery, Kosin University College of Medicine, Gospel Hospital, Busan, Korea, Department of Neurosurgery, Busan National University College of Medicine, Busan, Korea1 |
| 요추간반탈출증 환자에 대한 화학적 수핵용해술과 경피적 자동수핵제거술의 병용 요법 |
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승원배, 전병찬, 이형근, 송근성1 |
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고신대학교 복음병원 신경외과학교실, 부산대학교 의과대학 신경외과학교실1 |
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| Abstract |
Objective
This study was designed to investigate the efficacy of a combined procedure of automated percutaneous nucleo- tomy and low dose chemonucleolysis for the treatment of the patient with contained lumbar disc herniation.
Methods
The authors underwent 67 combined procedure of automated percutaneous nucleotomy(APN) and low-dose chemonucleolysis(LDC) between June 1994 and May 1997. All patients received low dose(1,000 IU) chymopapain injection, followed by an automated percutaneous nucleotomy. Among them, a retrospective assessment of 44 patients was performed at least 6 months after their index operation. The surgeon-performed outcome assessment was done using the Macnab's criteria.
Results
In 44 patients follow-up was obtained at least 6 months. The 6-month follow-up results according to Macnab's criteria were as follows; 88% of the patients reported a good to excellent result, 5% had a fair, 7% had showed no improvement. The relation between the change of the height of intervertebral space and the time course did not show statistical significance (p>0.05). The comparison between the satisfactory clinical outcome on the basis of Macnab's criteria and time course did not show statistical significance(p>0.05). Immediately after operation, there was no statistical significance between the amount of removed nucleus pulposus and clinical result(p>0.05). However, at the 6 month after operation, as the amount was much more, clinical result was better(p<0.05). There was no statistical significance between the time required at the removal and the clinical result(p>0.05). Three patients underwent open microdiscectomy. There was no major or minor complication.
Conclusion
The combination of low-dose chemonucleolysis and automated percutaneous nucleotomy appears to be an effective procedure for contained lumbar disc herniation.
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| Keywords:
Contained lumbar disc, Automated percutaneous nucleotomy, Low-dose chemonucleolysis |
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