TY - JOUR
T1 - Percutaneous lumbar disc decompression using the dekompressor
T2 - A prospective long-term outcome study
AU - McCormick, Zachary L.
AU - Slipman, Curtis
AU - Kotcharian, Ashot
AU - Chhatre, Akhil
AU - Bender, Frank J.
AU - Salam, Aleya
AU - Menkin, Serge
AU - Kennedy, David J.
AU - Plastaras, Christopher
N1 - Publisher Copyright:
© 2016 American Academy of Pain Medicine. All rights reserved.
PY - 2016/6/1
Y1 - 2016/6/1
N2 - Background Data. Few studies have investigated the long-term efficacy of percutaneous lumbar disc decompression (PLDD) with Dekompressor (Stryker, Kalamazoo, MI) for discogenic radicular pain that has failed conservative management. Objective. Determine long-term outcomes of Dekompressor PLDD for discogenic radicular pain. Methods. Prospective cohort study at a tertiary academic spine center of consecutive patients (12/2004–11/2005) with discogenic lumbosacral radicular pain who underwent PLDD with Dekompressor. Numerical Rating Scale (NRS) leg pain score and Oswestry Disability Index (ODI) score data were collected at 6 months and 1 year. These two measures, 5-point Likert scale patient satisfaction, and surgical rate data were collected at 8 years. Results. Seventy patients underwent PLDD. Forty and 25 patients were successfully contacted at 1-year and 8-year follow-up, respectively. Using intention to treat analysis, at 1 year and 8 years, NRS leg pain scores were reduced >50% in 47% (95% confidence interval [CI] 35%, 59%) and 29% (95% confidence interval [CI] 18%, 40%) of patients, respectively; ODI score improved >30% in 43% (CI 32%, 55%) and 26% (CI 19%, 41%) of patients, respectively. Of the patients who followed up at 8 years, 36% (CI 17%, 55%) had undergone surgery and the median satisfaction was “4” (interquartile range 2,5). Conclusions. While limited by loss-to-follow-up, this study suggests that treatment of discogenic lumbosacral radicular pain with Dekompressor results in decreased leg pain and disability and favorable satisfaction at long-term follow-up. Further study with adequate follow-up retention is needed to confirm that Dekompressor spares open spinal surgery.
AB - Background Data. Few studies have investigated the long-term efficacy of percutaneous lumbar disc decompression (PLDD) with Dekompressor (Stryker, Kalamazoo, MI) for discogenic radicular pain that has failed conservative management. Objective. Determine long-term outcomes of Dekompressor PLDD for discogenic radicular pain. Methods. Prospective cohort study at a tertiary academic spine center of consecutive patients (12/2004–11/2005) with discogenic lumbosacral radicular pain who underwent PLDD with Dekompressor. Numerical Rating Scale (NRS) leg pain score and Oswestry Disability Index (ODI) score data were collected at 6 months and 1 year. These two measures, 5-point Likert scale patient satisfaction, and surgical rate data were collected at 8 years. Results. Seventy patients underwent PLDD. Forty and 25 patients were successfully contacted at 1-year and 8-year follow-up, respectively. Using intention to treat analysis, at 1 year and 8 years, NRS leg pain scores were reduced >50% in 47% (95% confidence interval [CI] 35%, 59%) and 29% (95% confidence interval [CI] 18%, 40%) of patients, respectively; ODI score improved >30% in 43% (CI 32%, 55%) and 26% (CI 19%, 41%) of patients, respectively. Of the patients who followed up at 8 years, 36% (CI 17%, 55%) had undergone surgery and the median satisfaction was “4” (interquartile range 2,5). Conclusions. While limited by loss-to-follow-up, this study suggests that treatment of discogenic lumbosacral radicular pain with Dekompressor results in decreased leg pain and disability and favorable satisfaction at long-term follow-up. Further study with adequate follow-up retention is needed to confirm that Dekompressor spares open spinal surgery.
KW - Discectomy
KW - Intervertebral disc
KW - Low back pain
KW - Outcome assessment (health care)
KW - Percutaneous
KW - Radiculopathy
UR - http://www.scopus.com/inward/record.url?scp=85010850432&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85010850432&partnerID=8YFLogxK
U2 - 10.1093/pm/pnv122
DO - 10.1093/pm/pnv122
M3 - Article
C2 - 26917626
AN - SCOPUS:85010850432
SN - 1526-2375
VL - 17
SP - 1023
EP - 1030
JO - Pain Medicine (United States)
JF - Pain Medicine (United States)
IS - 6
ER -