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Pilot Multicenter Study to Assess the Efficacy of Percutaneous Herniectomy for Lumbar Radiculopathy Related to Disk Herniation 2014

Category Interventional Patrick Browaeys
Nicolas Theumann
Laurent Huwart
Olivier Hauger
Pauline Foti
Manuel Cifrian-Perez
Nicolas Amoretti
Purpose Multicenter prospective evaluation of the percutaneous herniectomy technique done under CT and fluoroscopy guidance for lumbar radiculopathy related to disk herniation. Materials & Methods Prospective IRB approuved study starting January 2012, including so far 93 patients gathered in four centers over three countries. Level L2-L3 was treated in 1 patient (1%), L3-L4 in 4 patients (4%), L4-L5 in 37 patients (40%), L5-S1 in 50 patients (54%), and 1 patient with simultaneous treatment of L4-L5 and L5-S1 levels (1%). The hernia location was postero-lateral in 73 cases (78%), foraminal in 12 cases (13%) and postero-medial in 8 cases (9%). Inclusion criteria were: radicular pain assessed both by refering physician and operator with disk herniation at the corresponding level confirmed by MRI, failure of conservative treatment and at least one corticosteroid foraminal infiltration, Huskisson Visual Analogic Scale (VAS) for pain >= 6/10 and persistance of disk hydration (hyper T2 signal). Exclusion criteria were sensitive deficit, evolving motor deficit or stable motor deficit Results Pooled data of the 4 centers give: VAS prior to intervention was 7.7±1.4. VAS was 1.9±1.7 (p Conclusion Percutaneous herniectomy under CT and fluoroscopy guidance seems to provide significant clinical amelioration, with consistent results in a multicenter evaluation, similar to previous monocenter data. References CT- and fluoroscopy-guided percutaneous discectomy for lumbar radiculopathy related to disc herniation: a comparative prospective study comparing lateral to medial herniated discs. Amoretti N, Huwart L, Marcy PY, Foti P, Hauger O, Boileau P. Skeletal Radiol. 2013 Jan;42(1):49-53