PERCUTANEOUS NUCLEOTOMY IN LUMBAR DISC HERNIATION - A PROSPECTIVE-STUDY

The purpose of this article is to present the clinical results of the prospective series of studies on percutaneous nucleotomy (PN) for lumb ar disc herniation and to introduce current criteria of patient select ion for PN. Since 1983, 107 patients were treated with PN (Hijikata's method), 85 of whom had a follow-up period of more than 2 years. Of th ese 85 patients, 54 had successful results. Clinical findings and vari ous imaging evaluations (eg, magnetic resonance imaging and computed t omography after discography) before PN, as well as operative findings, were used to study the surgical outcomes of both the successful and u nsuccessful groups. The results yielded the following new criteria for patient selection for PN: 1) age less than 40 years; 2) no perforatio n of the posterior longitudinal ligament and no degenerative canal ste nosis detected by computed tomography after discography; 3) no malform ation of the neural structure; 4) more than Grade 4 on manual testing of innervated muscles; and 5) more than 6 months of conservative treat ment before PN.