No indications for percutaneous lumbar discectomy?

Abstract

A questionnaire was used to assess the outcome of automated percutaneous lumbar discectomy (APLD), to correlate patients' data and to identify criteria for pain relief and patient satisfaction. Two hundred and thirty eight patients were operated on by APLD between 1988 and 1990. The questionnaire returned by 182 patients (76.4%) was suitable for evaluation. The mean follow-up was 2.5 years. Overall, 60% reported pain relief and 52% were satisfied with APLD. Conventional operations were carried out subsequently on 45 patients (25%). Bivariate and multivariate analyses were done for preoperative (age, gender, neurological deficit, Lasegue's sign, sports activity), perioperative (weight of disc material removed, level of APLD) and post-operative (conventional nucleotomy, change in condition, pain relief, satisfaction, sports activity, return to work, compensation claims) parameters. The only significant parameters for improvement in condition and pain relief was age, where patients younger than 41 do better. Risk factors for reoperation were a positive Lasegue's sign and over 41 years of age. Patient satisfaction was significantly higher for patients without sensory deficit preoperatively.