Revel M, Payan C, Vallee C, Laredo J D, Lassale B, Roux C, Carter H, Salomon C, Delmas E, Roucoules J
Department of Rheumatology, Hôpital Cochin, Paris, France.
Spine (Phila Pa 1976). 1993 Jan;18(1):1-7. doi: 10.1097/00007632-199301000-00001.
A randomized clinical trial was conducted to compare the results of automated percutaneous discectomy with those of chemonucleolysis in 141 patients with sciatica caused by a disk herniation; 69 underwent automated percutaneous discectomy and 72 were subjected to chemonucleolysis. The principle outcome was the overall assessment of the patient 6 months after treatment. Treatment was considered to be successful by 61% of the patients in the chemonucleolysis group compared with 44% in the automated percutaneous discectomy group. At 1-year follow-up, overall success rates were 66% in the chemonucleolysis group and 37% in the automated percutaneous group. Within 6 months of treatment, 7% of the patients in the chemonucleolysis group and 33% in the discectomy group underwent subsequent open surgery. The complication rates of both treatment groups were low, with the exception of a high rate of low-back pain in the chemonucleolysis group (42%). The results of this trial confirm previous controlled studies on chemonucleolysis and suggest that controlled studies should be carried out before automated percutaneous discectomy can be considered a useful intervention.
开展了一项随机临床试验，比较141例因椎间盘突出症导致坐骨神经痛患者的经皮自动椎间盘切除术与化学髓核溶解术的治疗结果；69例接受经皮自动椎间盘切除术，72例接受化学髓核溶解术。主要结局是治疗6个月后对患者的总体评估。化学髓核溶解术组61%的患者认为治疗成功，而经皮自动椎间盘切除术组为44%。在1年随访时，化学髓核溶解术组的总体成功率为66%，经皮自动椎间盘切除术组为37%。治疗后6个月内，化学髓核溶解术组7%的患者和椎间盘切除术组33%的患者接受了后续的开放性手术。两个治疗组的并发症发生率都很低，但化学髓核溶解术组下腰痛发生率较高（42%）。该试验结果证实了先前关于化学髓核溶解术的对照研究，并表明在经皮自动椎间盘切除术被视为一种有效的干预措施之前，应开展对照研究。
