gms | German Medical Science

Objective: The percutaneous decompressor operation is a minimally invasive within-disc treatment option for chronic low back pain. It is based on the principle of reducing pressure and removing tissue in the nucleus pulposus. The paper reports on the observation of the course of recovery of patients treated with this method with the aim of assessing evidence for its effectiveness.

Methods: Between February and December 2005, 31 patients were treated using the percutaneous decompressor operation in our department. Data acquisition was performed prospectively. Inclusion criteria stated that only patients currently suffering from chronic low back pain with or without symptoms of radiculopathy be included in the study. Clinical symptoms were documented using a visual analogue scale (VAS) for pain as well as the patient’s age, sex, weight, body mass index (BMI) and smoking habits. The duration of symptoms in months was also recorded. All patients underwent percutaneous disc decompression under intraoperative X-ray guidance and with reference to CT images. All patients were asked to attend follow-up six and 12 months postoperatively in our clinic.

Results: The mean age of the 13 women and 18 men included in this study was 42 (range 18 – 74). The mean duration of symptoms was 21 months (range 1 – 120 months). 42% were smokers. The mean BMI was 26.4 (range 17.4 – 42.4). One patient had to undergo open and microsurgical operations during the six month postoperative period. 73% of patients experienced an improvement of at least 50% in their VAS pain score on the first postoperative day, 60% after six months and 57% after one year. No significant differences were observed in the degree of anaesthetic required, inability to work or restriction in day to day living.

Conclusions: Percutaneous decompression of prolapsed lumbar intervertebral discs is an effective, minimally invasive treatment method for chronic low back pain with or without a radicular pain component.