Department of Radiology, Hôpital archet 2, Centre Hospital-Universitaire de Nice, 151, route de saint antoine de Ginestière, 06200, Nice, France.
Skeletal Radiol. 2013 Jan;42(1):49-53. doi: 10.1007/s00256-012-1422-5. Epub 2012 May 29.
To evaluate and compare two groups of patients with sciatica due to intervertebral disc herniation with no neurologic deficit. The groups consisted of patients with intervertebral disc herniation in a medial location (group 1) and those in a lateral location (group 2).
A total of 200 patients were included in the study and were followed for a minimum of 6 months. In our series, we treated 80 postero-lateral herniated discs (40% of cases), 46 postero-medial herniated discs (23%), and 74 foraminal herniated discs (37%). Level L3-L4 was treated in 30 cases (15%), L4-L5 in 98 cases (49%), and L5-S1 in 72 cases (36%). The procedure was performed under dual guidance: fluoroscopic and CT. A helical probe was activated. It penetrates the herniated disc and causes the pulpous material to be mechanically evacuated through the probe. All 200 patients were followed for a minimum of 6 months.
In group 1, the patients had a mean pain score of 7.9 ± 2.5 VAS units (range 6-10 units) prior to intervention. This was reduced to 3.2 ± 2.1 VAS units (range 0-10 units) at 48 h follow-up and increased to 3.9 ± 1.2 VAS units (range 0-10 VAS units) at 1 month follow-up and further reduced to 2.7 ± 1.2 units (range 0-10 VAS units) at 6 month follow-up. In group 2, the patients had a mean pain score of 8.2 ± 3.2 VAS units (range 6-10 units) prior to intervention. This was reduced to 2.8 ± 1.5 VAS units (range 0-10 units) at 48 h follow-up and decreased to 1.5 ± 0.9 VAS units (range 0-10 units) at 1 month and further reduced to 1.1 ± 0.5 VAS units (range 0-10 units) at 6 months.
Our study showed that results were more satisfactory for the hernia located laterally (postero-lateral, foraminal, and extra-foraminal) as compared to the hernia located posteromedially.
评估和比较两组无神经缺损的椎间盘突出症坐骨神经痛患者。两组患者的椎间盘突出部位分别为内侧（第 1 组）和外侧（第 2 组）。
本研究共纳入 200 例患者，随访时间至少 6 个月。在我们的系列研究中，我们治疗了 80 例后外侧型椎间盘突出症（40%）、46 例后内侧型椎间盘突出症（23%）和 74 例椎间孔型椎间盘突出症（37%）。L3-L4 水平治疗 30 例（15%），L4-L5 水平治疗 98 例（49%），L5-S1 水平治疗 72 例（36%）。该手术在双重引导下进行：透视和 CT。激活螺旋探头。它穿透椎间盘，并通过探头将髓核物质机械吸出。所有 200 例患者均随访至少 6 个月。
第 1 组患者术前平均疼痛评分为 7.9±2.5VAS 单位（6-10 单位），术后 48 小时随访时降至 3.2±2.1VAS 单位（0-10 单位），术后 1 个月随访时增至 3.9±1.2VAS 单位（0-10VAS 单位），术后 6 个月随访时进一步降至 2.7±1.2 单位（0-10VAS 单位）。第 2 组患者术前平均疼痛评分为 8.2±3.2VAS 单位（6-10 单位），术后 48 小时随访时降至 2.8±1.5VAS 单位（0-10 单位），术后 1 个月随访时降至 1.5±0.9VAS 单位（0-10 单位），术后 6 个月随访时进一步降至 1.1±0.5VAS 单位（0-10 单位）。
与后内侧疝相比，我们的研究表明外侧（后外侧、椎间孔和椎间孔外）疝的结果更令人满意。
