epartment of Anesthesiology and Pain Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Pain Physician. 2022 Jan;25(1):E157-E164.
The navigable percutaneous disc decompression (PDD) device L'DISQ is an effective and safe option for the treatment of lumbar discogenic pain. However, few studies have evaluated the prognostic factors of successful PDD using this device.
This study aimed to evaluate the prognostic factors associated with the successful outcome of PDD using the L'DISQ for treating lumbar discogenic pain by following up patients before and one, 2, 3, and 6 months after the procedure.
Retrospective cohort study.
Tertiary university hospital.
A successful outcome was defined as a >= 50% reduction in the numeric rating scale scores for pain and a >= 40% reduction in the Oswestry Disability Index scores at 6 months after the procedure. Clinical parameters and patient demographics, including pain duration, history of surgery, number of treatment levels, and the radiographic findings of lumbar magnetic resonance imaging (MRI), were also examined.
Of the 106 patients included, 80 (75.5%) had successful outcomes at 6 months. Multivariable logistic regression analysis revealed that the presence of high-intensity zones (HIZs) (P = 0.016) was an independent positive predictor of successful PDD outcomes; conversely, migration of the herniated disc (P = 0.017) and bilaterally herniated discs (P = 0.001) were negative predictors.
The limitations of this study were its retrospective design, absence of a control group, and difficulty in predicting the effect when multiple levels were involved because of the use of MRI characteristics of the disc as a predictor.
The presence of HIZs, the absence of migration of herniated discs, and the presence of unilaterally herniated discs are positive predictors of successful outcomes of PDD using the L'DISQ.
可导航经皮椎间盘减压（PDD）装置 L'DISQ 是治疗腰椎间盘源性疼痛的有效且安全的选择。然而，很少有研究使用该设备评估 PDD 成功的预测因素。
本研究旨在通过在手术前和手术后 1、2、3 和 6 个月对患者进行随访，评估使用 L'DISQ 治疗腰椎间盘源性疼痛的 PDD 成功的相关预测因素。
回顾性队列研究。
三级大学医院。
成功的结果定义为术后 6 个月时疼痛的数字评分量表评分至少降低 50%，Oswestry 残疾指数评分至少降低 40%。还检查了临床参数和患者人口统计学资料，包括疼痛持续时间、手术史、治疗水平数以及腰椎磁共振成像（MRI）的放射学发现。
在纳入的 106 例患者中，80 例（75.5%）在 6 个月时取得了成功的结果。多变量逻辑回归分析显示，高信号区（HIZ）的存在（P = 0.016）是 PDD 结果成功的独立正预测因子；相反，椎间盘突出的迁移（P = 0.017）和双侧椎间盘突出（P = 0.001）是负预测因子。
本研究的局限性在于其回顾性设计、缺乏对照组以及由于将椎间盘的 MRI 特征用作预测因子，当涉及多个水平时预测效果的困难。
HIZ 的存在、椎间盘突出无迁移和单侧椎间盘突出是使用 L'DISQ 进行 PDD 成功的正预测因子。
