A prospective randomized trial of chemonucleolysis and conventional disc surgery in single level lumbar disc herniation
| Autor: | A. Hamilton, W. G. Kernohan, K. P. Muralikuttan, R. A. B. Mollan, I. V. Adair |
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| Předmět: |
Adult
Male medicine.medical_specialty Time Factors medicine.medical_treatment Chymopapain Lumbar vertebrae law.invention Randomized controlled trial law Discectomy medicine Humans Orthopedics and Sports Medicine Hernia Prospective Studies Prospective cohort study Lumbar Vertebrae business.industry Intervertebral Disc Chemolysis medicine.disease Surgery Clinical trial Intervertebral disk medicine.anatomical_structure Treatment Outcome Costs and Cost Analysis Female Neurology (clinical) business Intervertebral Disc Displacement |
| Zdroj: | Scopus-Elsevier |
| Popis: | The role of chemonucleolysis as an alternative to disc surgery is still disputed. The authors conducted a prospective randomized controlled trial of chemonucleolysis and conventional disc surgery involving 92 patients with L4-5 or L5-S1 disc herniation who failed to respond to conservative treatment. There were 46 patients in each group, matched for demographic, clinical characteristics, and co-interventions. Independent examiners assessed patients before treatment, at 6 weeks after, 3 months after, and 1 year after treatment. A comprehensive method of outcome assessment involving physiological outcome, functional outcome, cost outcome, and psychological outcome was employed. Nine chemonucleolysis patients and one disc surgery patient required additional surgery for failure of initial treatment (P less than 0.02). The outcomes at 6 weeks and at 3 months were better in the surgical group, but at 1 year the differences were not significant. The authors conclude that chemonucleolysis as a minimally invasive technique produces inferior short-term results and offers no advantage over conventional discectomy. |
| Databáze: | OpenAIRE |
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