Abstract
We analyzed the results percutaneous nucleotomy that was performed on 16 patients with lumbar disc herniation following ineffective conservative treatment. Twelve patients were males and three were females. Their ages at nucleotomy ranged from 16 to 39 years (mean, 22 years). The level of the disc involved was L4/5 in 12 patients and L5/S1(L6) in 4. Subjective symptoms and objective signs evaluated by Japanese Orthopaedic Association (JOA) scores were compared before and after the surgery. The mean improvement in the score was 59.4%. The improvement of 75 to 100% was seen in 9 patients, 50 to 74% in 2, 25 to 49% in 2, and less than 24% in 3. Greater improvement was found in patients with a puncture from the affected side in comparison with that normal side, indicating that the former was a preferred approach for nucleotomy. The 2 patients with the poorest improvement rate later underwent the surgical procedures and were found to have the subligamentous extrusion type. Extirpation scars were visualized in these patients by magnetic resonance imaging after percutaneous nucleotomy.
