Lee Sang Heon, Derby Richard, Sul Donggeun, Hong Young Ki, Ha Kang Wook, Suh Dongwon, Lee Sang Hoon, Yoon Hyung Suk, Yoo Seung Han, Lee Seok Jun, Park Hyeun Jun, Jung Yong Jin, Lee Jeong Eun, Kim Nack Hwan
Department of Physical Medicine and Rehabilitation, Korea University Medical Center.
Pain Med. 2015 Feb;16(2):266-73. doi: 10.1111/pme.12603. Epub 2014 Nov 13.
This study is a pilot study to assess the clinical outcomes of percutaneous disc decompression using the L'DISQ in patients with lumbar discogenic pain.
An institutional, prospective clinical data analysis.
We ablated the torn annulus using L'DISQ on 20 patients with axial low back pain for at least 3 months (average 29 months) unresponsive to conservative management. Before the therapeutic procedure, all the patients had been diagnosed with lumbar discogenic pain through provocation discography, which had confirmed the level of painful discs. The torn annulus was identified through lumbosacral magnetic resonance image and computed tomographic discogram. Baseline data were prospectively gathered before the procedure and at 1, 4, 12, 24, and 48 weeks post-procedure. Data included pain intensity (visual analog scale [VAS]), measure of disability (Oswestry Disability Index [ODI] and Rolando-Morris Disability Questionnaire [RM]), and health-related quality of life (Bodily Pain Scale of Short Form-36 version 2 [SF-36 BP]).
At 48 weeks, the VAS fell from 7.55 ± 1.28 to 3.60 ± 2.28 scores, the ODI and RM had decreased significantly, and the SF-36 BP showed significant improvement (P < 0.05). The success rates of procedure were 55.0% at 48 weeks. There were no complications with the exception of a minor venous bleeding at the site of needle puncture.
The L'DISQ device is specifically designed to ablate adjacent disc tissue using a wand that can be navigated into a torn annulus. Following ablation, we measured clinically significant pain improvement and decreased disability for patients with axial low back pain.
本研究是一项初步研究,旨在评估使用L'DISQ对腰椎间盘源性疼痛患者进行经皮椎间盘减压的临床效果。
一项机构性前瞻性临床数据分析。
我们使用L'DISQ对20例轴向性下腰痛患者进行了撕裂椎间盘纤维环消融术,这些患者至少有3个月(平均29个月)对保守治疗无反应。在治疗前,所有患者均通过激发性椎间盘造影被诊断为腰椎间盘源性疼痛,该检查确定了疼痛椎间盘的节段。通过腰骶部磁共振成像和计算机断层扫描椎间盘造影确定撕裂的椎间盘纤维环。前瞻性收集术前及术后1、4、12、24和48周的基线数据。数据包括疼痛强度(视觉模拟评分法[VAS])、残疾程度测量(Oswestry残疾指数[ODI]和罗兰-莫里斯残疾问卷[RM])以及健康相关生活质量(简明健康状况调查量表第2版身体疼痛量表[SF-36 BP])。
在48周时,VAS评分从7.55±1.28降至3.60±2.28,ODI和RM显著降低,SF-36 BP显示出显著改善(P<0.05)。48周时手术成功率为55.0%。除穿刺部位有少量静脉出血外,无其他并发症。
L'DISQ装置专门设计用于使用可插入撕裂椎间盘纤维环的棒状器械消融相邻椎间盘组织。消融术后,我们测量到轴向性下腰痛患者的疼痛有显著改善,残疾程度降低。