Percutaneous Laser Disc Decompression: In Low Back Pain or in Radicular Pain

Yıl 2022, Cilt: 17 Sayı: 1, 9 - 14, 21.03.2022

Kutsal Devrim Seçinti

https://doi.org/10.17517/ksutfd.840860

Öz

Objective: The efficacy of percutaneous laser disc decompression is still controversial due to inconsistencies between the studies. However, the reason for this discrepancy may be due to having different success levels in low back pain and leg pain. In this study, the response of both pain modalities to percutaneous laser disc decompression was examined separately.
Material and Methods: Results of 49 patients who underwent percutaneous laser disc decompression only for low back pain and 36 patients who underwent percutaneous laser disc decompression only for radicular pain were analyzed retrospectively. It was investigated on which pain type that percutaneous laser disc decompression was more effective. In addition, by examining the magnetic resonance images of the patients, it was determined whether there was a change in the size of the disc herniation.
Reults: Although statistically percutaneous laser disc decompression was effective in both types of pain, this effect was much more pronounced in the low back pain group. It was determined that percutaneous laser disc decompression did not reduce the size of the disc herniation, but still provided some reduction in radicular pain. It was determined that it was much more effective in low back without reducing the size of the disc herniation.
Conclusion: percutaneous laser disc decompression is more effective in low back pain. However, a reduction in the size of the disc herniation should not be expected.

Anahtar Kelimeler

Percutaneous laser disc decompression, Low back pain, Radicular pain

Destekleyen Kurum

Yok

Proje Numarası

Yok

Teşekkür

We would like to thank to Dr. İlke Evrim Seçinti for her contribution to the statistical analysis of the study.

Perkütan Lazer Disk Dekompresyonu: Bel Ağrısında mı, Radiküler Ağrıda mı?

Öz

Amaç: Perkütan lazer disk dekompresyonunun etkinliği, çalışmalar arasındaki tutarsızlıklar nedeniyle hala tartışmalıdır. Oysa bu tutarsızlığın nedeni, başarısının bel ağrısında ve bacak ağrısında birbirinden farklı olması olabilir. Bu çalışmada, her iki ağrı modalitesinin perkütan lazer disk dekompresyonuna yanıtı ayrı ayrı incelenmiştir.
Gereç ve Yöntemler: Yalnızca bel ağrısı nedeniyle perkütan lazer disk dekompresyonu uygulanan 49 hasta ile yalnızca radiküler ağrı nedeniyle perkütan lazer disk dekompresyonu uygulanan 36 hastanın sonuçları geriye dönük olarak incelendi. Perkütan lazer disk dekompresyonunun hangi ağrı tipinde daha etkili olduğu araştırıldı. Ayrıca hastaların manyetik rezonans görüntüleri incelenerek disk herniasyonunun boyutunda değişiklik olup olmadığı belirlendi.
Sonuçlar: İstatistiksel olarak perkütan lazer disk dekompresyonu her iki ağrı türünde de etkili olmasına rağmen, bu etki bel ağrısı grubunda çok daha belirgindi. İşlemin disk herniasyonunu küçültmediği ancak yine de radiküler ağrıda bir miktar azalma sağladığı belirlendi. Disk herniasyonunu küçültmeden belde çok daha etkili olduğu belirlendi.
Sonuç: Perkütan lazer disk dekompresyonu bel ağrısında daha etkilidir. Ancak disk herniasyonunun boyutunda bir azalma beklenmemelidir.

Anahtar Kelimeler

Perkütan lazer disk dekompresyonu, Bel ağrısı, Radiküler ağrı

Proje Numarası

Yok

Kaynakça

• 1- Ceylan A, Asik I. Percutaneous navigable intradiscal decompression in treatment of lumbar disc herniation: a single-center experience. Turk J Med Sci. 2019;49:519-524.
• 2- Davis TT, Delamarter RB, Sra P, Goldstein TB. The IDET procedure for chronic discogenic low back pain. Spine (Phila Pa 1976). 2004;29:752-756.
• 3- Hijikata S. Percutaneous nucleotomy: a new concept technique and 12 years’ experience. Clin Orthop Relat Res. 1989;238:9-23.
• 4- Saal JA, Saal JS. Intradiscal electrothermal treatment for chronic discogenic low back pain. A prospective outcome study with a minimum 1-year follow-up. Spine (Phila Pa 1976). 2000;25:2622-2627.
• 5- Saal JS, Saal JA. Management of chronic discogenic low back pain with a thermal intradiscal catheter: a preliminary report. Spine (Phila Pa 1976). 2000;25:382-388.
• 6- Singh V, Piryani C, Liao K, Nieschulz S. Percutaneous disc decompression using coblation (nucleoplasty) in the treatment of chronic discogenic pain. Pain Physician. 2002;5: 250-259.
• 7- Webster BS, Verma S, Pransky GS. Outcomes of workers’ compensation claimants with low back pain undergoing intradiscal electrothermal therapy. Spine (Phila Pa 1976). 2004;29:435-441.
• 8- Pauza KJ, Howell S, Dreyfuss P, JH Peloza, K Dawson. A randomised, placebo-controlled trial of intradiscal electrothermal therapy for the treatment of discogenic low back pain. Spine J. 2004;4:27-35.
• 9- Freeman BJC. IDET: a critical appraisal of the evidence. Eur Spine J. 2006;15 (Suppl. 3): S448–S457.
• 10- Freedman BA, Cohen SP, Kuklo TR, Lehman RA, Larkin P, Giuliani JR. Intradiscal electrothermal therapy (IDET) for chronic low back pain in active-duty soldiers: 2-year follow-up. Spine J. 2003;3:502-509.
• 11- Cohen SP, Larkin T, Abdi S. Risk factors for failure and complications of intradiscal electrothermal therapy: a pilot study. Spine (Phila Pa 1976). 2003;28:1142-1147.
• 12- Binch ALA, Cole AA, Breakwell LM, Michael ALR, Chiverton N, Creemers LB et al. Nerves are more abundant than blood vessels in the degenerate human intervertebral disc. Arthritis Res Ther. 2015;17:370.
• 13- Wu B, Yang L, Peng B. Ingrowth of Nociceptive Receptors into Diseased Cervical Intervertebral Disc Is Associated with Discogenic Neck Pain. Pain Med. 2019:20(6):1072-1077.