Treatment of contained lumbar disc herniations using radiofrequency assisted micro-tubular decompression and nucleotomy: four year prospective study results

Article Figures & Data

Table 1

INCLUSION CRITERIA	EXCLUSION CRITERIA
concordant clinical signs to CT; MRI positive SLRT, axial pain, coughing,sensory signs	progressive neurological deficits
VAS >5 leg and back pain	extruded, sequestrated herniation (MRI-direct neuraldecompression)
symptomatic contained disc herniation	severe stenosis
discogenic back pain	severe degeneative disc disease with end stage collapse >50%
herniation by posterior ligament not greater than 1/3 the sagital diameter ofthe spinal channel	activated osteochondritis, fracture, tumor, discitis
6 weeks failed conservative treatment	cauda equina syndrom
no leakage of contrast/dye into the spinal channel during discography	fixed motor deficit
slight neurological deficits	oversegmental instability - spondylolisthesis

Table 2

Study (Reference)	Recurrence Rate	Years	Outcome	Type of surgery
Hellinger 2014 (32–33)	6.3% short < 3 Mo 6.3% long >3M	4 yrs	83.0%	DiscFX
Hellinger, Feldmann 2010 (34)	4%	6 Months 2 yrs	82.2%	DiscFX
Jannson et al. 2004 (16)	10%	10 yrs	only reoperation	Microsurgery
Häkkinen et.al 2007 (48)	11%	5 yrs	only reoperation	Microsurgery
Ostermann et al. 2003 (49)	14%	1987-1998 N = 35.309	only reoperation	Lumbar open dorsal Discectomy
Carragee (31)	15%	2-6 yrs	24% for contained hernias	Open dorsal Discectomy for sciatica
Hoogland / Gibson / Iprenburg / Ruetten / Tsou (17–19–22–23–24–48)	6.9% (HO) 8% (G) 13% (I) 6.3% (R) 15% (T)	2-4 yrs	75- 89%	ENDOSCOPY
Hoogland (24)	1.6% Hoogland Endo mit Chemo	2yrs	Endo Group 85.4% Endo + Chymo 93.3%	ENDOSCOPY with Chymo
Manchikanti et al. 2009 (53)		2 yrs	56%	Nucleoplasty
Choy, Tassi,Hellinger S.H. Lee (52)	5%	up to 8 yrs	70-89%	Laserdiscus- decompression
Wardlaw (54)	10%	1 / 10-13/ 24 -27 yrs	95% / 72% / 63%	Chymopapaine