Comparison the Postoperation Results of Discectomy with Nucleoplasty in Single Cervical Disc Herniation

Document Type : Original Article

Authors

1 Department of Neurosurgery, Medical School, Isfahan University of Medical Sciences, Isfahan, Iran

2 Department of General Anesthesiology, Imam-Hossein General Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Abstract

Background: The standard treatment for cervical disc herniation is open discectomy surgery but some of techniques, such as nucleoplasty were applied by neurosurgeons in recent decade. The aim of this study was to compare the postoperation results of open discectomy and nucleoplasty methods in people suffering from single cervical disc herniation. Materials and Methods: In a clinical trial study that performed during 2012–2013, 70 patients who candidate for neck surgery were selected and randomly divided into two groups. The first group was operated with standard discectomia and the second group was operated with nucleoplasty method. All patients were followed neck pain, upper limb pain and common complications included discitis, infection and hematoma in 2 weak, 1, 2, 3, and 6 months after operation. All data were analyzed using SPSS software. Results: Cervical pain mean from before the operation to 6 months after operation had no significant difference between two groups, but radicular pain had significant difference in 2 and 3 months after operation (P < 0.05). It is notable that after operation it is not observed any discitis, infection and hematoma of operated place. Conclusion: Doing nucleoplasty surgery in patients suffering from single cervical disc herniation causes decrease in cervical and radicular pain, at least as the same as discectomy method. Since now it is possible in our country to apply this method and on the other hand, in this method, time of surgery, postoperation complications, hospital costs, and period of convalescence is low, it is preferred in patients suffering from cervical disc and its application is advised.

Keywords

1.
Long DM. Decision making in lumbar disc disease. Clin Neurosurg 1992;39:36-51.  Back to cited text no. 1
[PUBMED]    
2.
Chen YC, Lee SH, Chen D. Intradiscal pressure study of percutaneous disc decompression with nucleoplasty in human cadavers. Spine (Phila Pa 1976) 2003;28:661-5.  Back to cited text no. 2
    
3.
Kambin P, Brager MD. Percutaneous posterolateral discectomy. Anatomy and mechanism. Clin Orthop Relat Res 1987; 223:145-54.  Back to cited text no. 3
    
4.
Kambin P, Schaffer JL. Percutaneous lumbar discectomy. Review of 100 patients and current practice. Clin Orthop Relat Res 1989; 238:24-34.  Back to cited text no. 4
    
5.
Karasek M, Bogduk N. Twelve-month follow-up of a controlled trial of intradiscal thermal anuloplasty for back pain due to internal disc disruption. Spine (Phila Pa 1976) 2000;25:2601-7.  Back to cited text no. 5
    
6.
Albert TJ, Balderston RA, Heller JG, Herkowitz HN, Garfin SR, Tomany K, et al. Upper lumbar disc herniations. J Spinal Disord 1993;6:351-9.  Back to cited text no. 6
[PUBMED]    
7.
Heliövaara M, Impivaara O, Sievers K, Melkas T, Knekt P, Korpi J, et al. Lumbar disc syndrome in Finland. J Epidemiol Community Health 1987;41:251-8.  Back to cited text no. 7
    
8.
Schwetlick G. Microsurgery in lumbar disk operations. Possibilities, methods and results. Orthopade 1998;27:457-65.  Back to cited text no. 8
[PUBMED]    
9.
Welch WC, Gerszten PC. Alternative strategies for lumbar discectomy: Intradiscal electrothermy and nucleoplasty. Neurosurg Focus 2002;13:E7.  Back to cited text no. 9
[PUBMED]    
10.
Sharps LS, Isaac Z. Percutaneous disc decompression using nucleoplasty. Pain Physician 2002;5:121-6.  Back to cited text no. 10
[PUBMED]    
11.
Singh V, Piryani C, Liao K, Nieschulz S. Percutaneous disc decompression using coblation (nucleoplasty) in the treatment of chronic discogenic pain. Pain Physician 2002;5:250-9.  Back to cited text no. 11
[PUBMED]    
12.
Singh V, Piryani C, Liao K. Evaluation of percutaneous disc decompression using coblation in chronic back pain with or without leg pain. Pain Physician 2003;6:273-80.  Back to cited text no. 12
[PUBMED]    
13.
Reddy AS, Loh S, Cutts J, Rachlin J, Hirsch JA. New approach to the management of acute disc herniation. Pain Physician 2005;8:385-90.  Back to cited text no. 13
[PUBMED]    
14.
Bak KH, Oh SH, Kim JM, Yi HJ, Hwan CJ, Kim CH. Nucleoplasty as an alternative intradiscal therapy: Indications and technique. State Art Minim Invasive Spine Surg 2005;12:7-14.  Back to cited text no. 14
    
15.
Salvatore M, Giovanni S, Matteo M. Percutaneous nucleoplasty in the treatment of discal lumbar pain, 2 years follow-up. J Cardiovasc Intervent Radiol 2007;30:426-32.  Back to cited text no. 15
    
16.
Zhu H, Zhou XZ, Cheng MH, Shen YX, Dong QR. The efficacy of coblation nucleoplasty for protrusion of lumbar intervertebral disc at a two-year follow-up. Int Orthop 2011;35:1677-82.  Back to cited text no. 16
[PUBMED]    
17.
Halim W, Wullems JA, Lim T, Aukes HA, van der Weegen W, Vissers KC, et al. The long-term efficacy and safety of percutaneous cervical nucleoplasty in patients with a contained herniated disk. Pain Pract 2013;13:364-71.  Back to cited text no. 17
[PUBMED]    
18.
Li J, Yan DL, Zhang ZH. Percutaneous cervical nucleoplasty in the treatment of cervical disc herniation. Eur Spine J 2008;17:1664-9.  Back to cited text no. 18
[PUBMED]    
19.
Peter C, William C, Joseph T, King JR. Quality of life assessment in patients undergoing nucleoplasty-based precutaneous discectomy invited submission from the joint section meeting disorders of the spine and peripheral nerves. J Neurosurg: Spine 2006;4:36-42.  Back to cited text no. 19
    
20.
Jorgen A. Current evidence of percutaneous nucleoplasty for the cervical herniated disk: A systematic review. Neth Pain Pract 2013;14:121-2.  Back to cited text no. 20