Shabat Shay, David Rami, Folman Yoram
Unit of Spinal Surgery, Sapir Medical Center, Kfar-Saba, Israel.
J Spinal Disord Tech. 2012 Aug;25(6):329-32. doi: 10.1097/BSD.0b013e318220dbe9.
A prospective study of all patients with either mechanical back pain or radicular back pain who underwent nucleoplasty and were followed up prospectively.
To investigate the effectiveness of nucleoplasty procedure in terms of pain and quality of life using the visual analog scale and Oswestry disability questionnaires.
Nucleoplasty is a method of increasing popularity in the past few years. It has a role when dealing with pain of spinal origin either radicular or both radicular and mechanical after conservative treatment has failed and before open procedure.
Eighty-seven patients with a minimal follow-up of 1 year were prospectively followed after they underwent nucleoplasty procedure for either radicular or a combination of radicular and mechanical low back pain. All patients underwent physical examination and completion of visual analog scale score and Oswestry Disability questionnaires after 1, 3, 6, and 12 months. Thirty-nine of them were followed after 2 years.
After 1 month, 66 patients (76%) were satisfied with the results. After 3 months, 60 patients (69%) had significant pain relief, whereas in 27 cases (31%) there was no improvement. After 6 months of follow-up, 57 patients (66%) had pain relief and in 30 cases (34%) there was no effect. At 12 months of follow-up, 55 patients (65%) showed good results and 30 patients (35%) had no effect. In the case of the 39 patients who were followed for 24 months, 23 patients (59%) had significant pain relief. A statistically significant reduction in the Oswestry index was also noted for the series in all intervals. Minor complication occurred in 23 patients (26%) who had transient discomfort and burning pain at the insertion site of the nucleoplasty wire.
We concluded that the nucleoplasty technique is a safe and effective procedure for radicular or combined radicular and mechanical low back pain and should be used in selected cases before open surgery after conservative treatment has failed.
对所有因机械性背痛或根性背痛接受髓核成形术并进行前瞻性随访的患者进行的一项前瞻性研究。
使用视觉模拟量表和奥斯维斯特功能障碍问卷，研究髓核成形术在疼痛和生活质量方面的有效性。
髓核成形术在过去几年中越来越受欢迎。在保守治疗失败且尚未进行开放手术之前，它在处理神经根性或神经根性与机械性混合的脊柱源性疼痛方面发挥着作用。
87例患者接受了髓核成形术，治疗神经根性或神经根性与机械性混合的下腰痛，对其进行前瞻性随访，最短随访时间为1年。所有患者在1、3、6和12个月后接受体格检查，并完成视觉模拟量表评分和奥斯维斯特功能障碍问卷。其中39例患者进行了2年的随访。
1个月后，66例患者（76%）对结果满意。3个月后，60例患者（69%）疼痛明显缓解，27例患者（31%）无改善。随访6个月时，57例患者（66%）疼痛缓解，30例患者（34%）无效。随访12个月时，55例患者（65%）效果良好，30例患者（35%）无效。在39例进行了24个月随访的患者中，23例患者（59%）疼痛明显缓解。在所有时间段内，该系列患者的奥斯维斯特指数也有统计学意义的降低。23例患者（26%）出现轻微并发症，在髓核成形术钢丝插入部位有短暂不适和灼痛。
我们得出结论，髓核成形术技术对于神经根性或神经根性与机械性混合的下腰痛是一种安全有效的手术方法，在保守治疗失败后，应在开放手术前的特定病例中使用。
