Current Concepts in Intradiscal Percutaneous Minimally Invasive Procedures for Chronic Low Back Pain
Autor: | Ioannis Gkiatas, Emilios E. Pakos, Dimitrios Papadopoulos, Antonios E. Spiliotis, Ioannis D. Gelalis, Marios D. Vekris, Anastasios V. Korompilias |
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Jazyk: | angličtina |
Rok vydání: | 2019 |
Předmět: |
medicine.medical_specialty
Disc herniation Percutaneous disc herniation Annular tears business.industry Decompression discogenic pain General Medicine Review Article 030218 nuclear medicine & medical imaging Surgery Chronic low back pain 03 medical and health sciences 0302 clinical medicine intradiscal minimally invasive interventions Back pain chronic low back pain Medicine medicine.symptom Outcome data business Adverse effect 030217 neurology & neurosurgery Minimally invasive procedures |
Zdroj: | Asian Journal of Neurosurgery |
ISSN: | 2248-9614 1793-5482 |
Popis: | Study Design: A systemic review of thermal annular procedures (TAPs) and percutaneous disk decompression procedures (PDDPs) for the treatment of discogenic chronic low back pain (CLBP) was conducted. Objective: The objective of this review is to evaluate and to compare the effectiveness of TAPs and PDDPs in treating discogenic CLBP and to assess the frequency of complications associated with those procedures. Materials and Methods: English-language journal articles were identified through computerized searches of the PubMed database and bibliographies of identified articles and review papers. Articles were selected for inclusion if percutaneous minimally invasive procedures were the treatment options for patients with CLBP and if follow-up outcome data included evaluations of back pain severity, functional improvement, and/or incidence of complications. For this review, 27 studies were included. Results: Intradiscal electrothermal therapy (IDET) procedure in properly selected patients may eliminate or delay the need for surgical intervention for an extended period, whereas few adverse effects have been reported. In contrast to IDET, there is far less literature on the effectiveness of radiofrequency annuloplasty and intradiscal biacuplasty procedures. Nucleoplasty is a potentially effective treatment option for patients with contained disc herniation, while the procedure is well tolerated. Increased success rates have been found for percutaneous laser disc decompression and automated percutaneous lumbar discectomy in strictly selected patients. Conclusions: These procedures can be effective and may obviate the need for surgery completely. Further prospective randomized sham-controlled trials with higher quality of evidence are necessary to confirm the efficacy of these procedures. |
Databáze: | OpenAIRE |
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