The Journal of Bone and Joint Surgery, Vol 77, Issue 4 578-584, Copyright © 1995 by Journal of Bone and Joint Surgery, Inc
Percutaneous lumbar discectomy. Preoperative and postoperative magnetic resonance imaging
RB Delamarter, MW Howard, T Goldstein, AL Deutsch, JH Mink and EG Dawson
Department of Orthopaedic Surgery, University of California, Los Angeles School of Medicine 90024, USA.
We evaluated magnetic resonance imaging studies of thirty patients before
and after a contained herniation of a lumbar disc was treated with a
percutaneous lumbar discectomy. The imaging studies were evaluated to
determine whether the preoperative appearance of the herniated disc was
predictive of the outcome of percutaneous discectomy and also to determine
a possible mechanism of action of the procedure in the relief of symptoms.
The index operation was successful in seventeen (57 per cent) of the thirty
patients. The preoperative imaging studies showed no differences in the
appearance of the discs that went on to have a successful result and those
that went on to have an unsuccessful result. Imaging studies made four to
six weeks after the operation showed no measurable changes in the
morphology of the disc. Imaging studies made a mean of fourteen months
after the operation showed no changes in the morphology of the disc in
twenty-four (80 per cent) of the patients, irrespective of the clinical
outcome. Only three of the seventeen patients who had a successful result
had a reduction of more than two millimeters in the size of the herniated
segment, and two of the thirteen patients who had an unsuccessful result
had an increase of more than one millimeter in the size of the herniated
segment. We found that preoperative imaging studies cannot predict the
clinical outcome of percutaneous lumbar discectomy.(ABSTRACT TRUNCATED AT
250 WORDS)
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