Department of Anesthesiology, Pain Management Center, Dicle University, Diyarbakir, Turkey.
Med Sci Monit. 2011 Aug;17(8):CR461-466. doi: 10.12659/MSM.881908.
Over the last several decades there has been a general trend toward reduction and minimalization in surgical treatment of chronic back pain, since open surgery brings complications in small and contained disc herniations instead of achieving expected success. Attention has been focussed on percutaneous nucleoplasty due to the limited success of other minimally invasive methods, as well due to their associated complications. However, there have been few studies in the English literature with a follow-up period of more than 1 year.
MATERIAL/METHODS: Patients with chronic disc herniations having more significant radicular leg pain, who did not respond to non-invasive treatment methods and for whom open surgery was not an option were selected for percutaneous nucleoplasty application. Upon intervention, patients were prospectively questioned by an independent physician regarding pain, physical improvement, and operation satisfaction at 1, 6, 12 and 24 months. Pain was evaluated with VAS, and physical improvement was evaluated based on the Oswestry Disability Index.
Mean VAS that was 8.7±1.1 before the procedure was determined to be 3.4±1.9 at 24 months follow-up. At the latest follow-up, 87.5% of the patients reported a 30% or higher decrease in their pain. While Oswestry scores were 76.1±10.2 in the beginning, they went down to 33.9±14.9 at the end of 2 years. The percent of those stating "good" and "excellent" satisfaction was 66% (23 persons) on the last follow-up.
While it is once more shown that nucleoplasty is a safe method, it is also shown that its effectiveness continues at the end of 2 years.
在过去几十年中，慢性腰痛的手术治疗总体上呈现出减少和最小化的趋势，因为开放性手术在小而局限的椎间盘突出症中会带来并发症，而不是取得预期的成功。由于其他微创方法的效果有限，以及它们相关的并发症，人们开始关注经皮髓核成形术。然而，在英文文献中，只有少数研究的随访时间超过 1 年。
材料/方法：选择患有慢性椎间盘突出症且神经根性腿痛较为严重的患者，这些患者对非侵入性治疗方法没有反应，且开放性手术不是选择，适合进行经皮髓核成形术。在干预时，一位独立的医生前瞻性地询问患者疼痛、身体改善和手术满意度，时间分别为 1、6、12 和 24 个月。疼痛通过 VAS 进行评估，身体改善根据 Oswestry 残疾指数进行评估。
术前平均 VAS 为 8.7±1.1，24 个月随访时降至 3.4±1.9。在最近的随访中，87.5%的患者报告疼痛减轻了 30%或以上。Oswestry 评分在开始时为 76.1±10.2，2 年后降至 33.9±14.9。在最后一次随访时，有 66%（23 人）表示“良好”和“优秀”的满意度。
虽然再次表明髓核成形术是一种安全的方法，但也表明其有效性在 2 年后仍在持续。
