Atraumatic CT-controlled percutaneous laser nucleotomy

Abstract

The main aim of percutaneous nucleotomy techniques is to reduce the volume and pressure of the affected disc while leaving all other structures unaffected. Previously percutaneous discectomies were performed under fluoroscopic guidance with or without endoscopy. In this paper we describe the combination of CT-scanning and fluoroscopy for guidance of nucleo-tomes, lasers, microendoscopes and other microinstmments. The results of percutaneous laser nucleotomy performed on 116 out-patients with chronic back pain are reported. Immediate pain relief was obtained in 92% of the patients, and improvement of neurological deficits in 59%. After 6 weeks, 87% of patients were back at work. At follow-up, 1–17 months later, overall improvement of pain symptoms of 50–100% was present in 81% of the patients; the results were better in patients with longer follow-up times. Spon-dylodiscitis occurred in one patient and a second herniation with re-operation in five patients. These results show that effective treatment of di...