Dimitrios Filippiadis MD, Presenter: Nothing to Disclose

Alexios Kelekis, Abstract Co-Author: Speaker, ArthroCare Corporation Instructor, ArthroCare Corporation

Dimitrios Erginousakis, Abstract Co-Author: Nothing to Disclose

Nikolaos Ptohis, Abstract Co-Author: Nothing to Disclose

Elias Brountzos MD, Abstract Co-Author: Nothing to Disclose

Nikolaos L. Kelekis MD, Abstract Co-Author: Nothing to Disclose

Purpose of our study is to compare efficacy and long term results concerning pain reduction and mobility improvement between conservative therapy and percutaneous disc decompression (PDD) for intervertebral disc herniation treatment.

During the last 2 years we prospectively studied and compared (t-test) 2 homogeneous groups of 31 patients each (17/14 male/female, mean age 36±5.8 years) suffering from sciatica due to intervertebral disc herniation. Group A underwent conservative therapy (analgesics, anti-inflammatory drugs, muscle relaxants, physiotherapy) for 6 weeks achieving pain reduction and mobility improvement, whilst group B after unsuccessful 6 weeks conservative therapy underwent PDD. Pain reduction and mobility improvement were recorded on 3, 12, 24 months with clinical evaluation and a Visual Analogue Scale (0-10 units) questionnaire. Clinical evaluation included immediate and delayed follow up studies of patient’s general condition and neurological status. The VAS questionnaire helped assessing the pain relief, life quality and mobility improvement.

Group A presented a mean pain of 6.87±1.92 VAS units prior to conservative therapy which was reduced to 0.9±2.0 VAS units at 3 months after therapy, then increases to 3.96±3.44 VAS units at 12 months and further increases to 4.09±3.36 VAS units at 24 months. Group B presented a mean pain of 7.4±1.4 VAS units prior to PDD, which was reduced to 2.9±2.44 VAS units at 3 months after PDD, further reduced to 1.66±2.48 VAS units at 12 months and 1.6±2.4 at 24 months. No complications were noted. Comparing the results of the two groups a statistically significant difference was noted at 12 and 24 months.

PDD compared to conservative therapy presents statistically significant improvement at 12 and 24 months. It is an efficient, minimally invasive technique for treating symptomatic intervertebral disc hernias with significant (≥ 5.8 AVS units) and long lasting (≥ 24 months) results concerning pain reduction and mobility improvement.

Percutaneous decompression of intervertebral disc hernias can be proposed as initial treatment or attractive alternative prior to surgery

Filippiadis, D, Kelekis, A, Erginousakis, D, Ptohis, N, Brountzos, E, Kelekis, N, Comparative Prospective Study between Conservative Treatment and Percutaneous Disc Decompression for the Treatment of Intervertebral Disc Herniation.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8012909.html