PERCUTANEOUS NUCLEOTOMY IN LUMBAR DISC HERNIATION - PATIENT SELECTIONAND ROLE IN VARIOUS TREATMENTS

Patients in percutaneous nucleotomy who met our new criteria for patie nt selection in 1992 showed 73% successful results. The success rate w as not satisfactory in comparison with that (88%) in the open surgery through posterior approach (herniotomy), however. The purpose of this report is to re-evaluate 70 patients with follow-up more than 2 years based on imaging and clinical findings before percutaneous nucleotomy. In results, supplementary criteria such as two types of the combinati on of computed tomography discogram and computed tomography myelogram, continuation of the contrast medium in lateral view of discogram, and clinical findings characterized by sciatic pain were obtained to impr ove the success rate. Eighty-one percent of patients who met the new c riteria in 1992 and the supplementary criteria were identified in the successful group. The authors believe that percutaneous nucleotomy sho uld be considered as an independent operative procedure with results s imilar to open surgery, if the patient is selected strictly based on t hese criteria and supplementary criteria.