Annals of Rehabilitation Medicine

The Factors Associated With the Successful Outcomes of Percutaneous Disc Decompression in Patients With Lumbar Herniated Nucleus Pulposus: Sang Heon Lee, Yong Jin Jeong, Nack Hwan Kim, Hyeun Jun Park, Hyun-Joon Yoo, Soo Yung Jo; Ann Rehabil Med 2015;39(5):735-744. Published online October 26, 2015; DOI: https://doi.org/10.5535/arm.2015.39.5.735

Abstract
PDF

Objective

To determine clinical and radiological factors that predict the successful outcome of percutaneous disc decompression (PDD) in patients with lumbar herniated nucleus pulposus (HNP).

Methods

We retrospectively reviewed the clinical and radiological features of patients who underwent lumbar PDD from April 2009 to March 2013. Sixty-nine patients with lumbar HNP were studied. Clinical outcome was assessed by the visual analogue scale (VAS) and the Oswestry Disability Index (ODI). Multivariate logistic regression analysis was performed to assess relationship among clinical and radiological factors and the successful outcome of the PDD.

Results

The VAS and the ODI decreased significantly at 1 year follow-up (p<0.01). One year after PDD, the reduction of the VAS (ΔVAS) was significantly greater in the patients with pain for <6 months (p=0.03) and subarticular HNP (p=0.015). The reduction of the ODI (ΔODI) was significantly greater in the patients with high intensity zone (p=0.04). Multivariate logistic regression analysis revealed the following 5 factors that were associated with the successful outcome after PDD: pain duration for <6 months (odds ratio [OR]=14.036; p=0.006), positive straight leg raising test (OR=8.425, p=0.014), the extruded HNP (OR=0.106, p=0.04), the sequestrated HNP (OR=0.037, p=0.026), and the subarticular HNP (OR=10.876, p=0.012).

Conclusion

PDD provided significant improvement of pain and disability of patients. The results of the analysis indicated that the duration of pain <6 months, positive straight leg raising test, the subarticular HNP, and the protruded HNP were predicting factors associated with the successful response of PDD in patients with lumbar HNP.

Citations

Citations to this article as recorded by

Obesity and Workers’ Compensation in the Setting of Minimally Invasive Lumbar Decompression
Madhav R. Patel, Kevin C. Jacob, Michael C. Prabhu, Nisheka N. Vanjani, Hanna Pawlowski, Kanhai Amin, Kern Singh
World Neurosurgery.2022; 164: e341. CrossRef
Factors Predicting Successful Outcome for Ozone Chemonucleolysis in Lumbar Disk Herniation
Matteo Luigi Giuseppe Leoni, Annalisa Caruso, Fabrizio Micheli
Pain Practice.2021; 21(6): 653. CrossRef
Posture control in patients with herniated nucleus pulposus in cervical and lumbosacral spine subjected to operative treatment
Grzegorz Przysada, Agnieszka Guzik, Izabela Rosak-Matuszewska, Mariusz Drużbicki, Andżelina Wolan-Nieroda, Marek Sobolewski, Justyna Podgórska-Bednarz, Andrzej Maciejczak
Journal of Back and Musculoskeletal Rehabilitation.2018; 31(5): 795. CrossRef
Aseptic Spondylodiscitis Resulting from Intradiscal Radiofrequency Ablation (IDRA) in Patients with Herniated Disc Disease: A Report of Ten Cases
Farid Yudoyono, Do Young Kim, Dong Kyu Chin, Dong Ah Shin
Journal of Minimally Invasive Spine Surgery and Technique.2018; 3(1): 13. CrossRef

5,901 View
83 Download
3 Web of Science
4 Crossref

Effect of Spinal Decompression Therapy Compared with Intermittent Mechanical Traction in Lumbosacral Disc Herniation.: Kim, Hee Sang , Yun, Dong Hwan , Huh, Ki Yun; J Korean Acad Rehabil Med 2008;32(3):319-323.

Abstract
PDF

Objective
To compare the effects of intermittent mechanical traction with spinal decompression therapy (SDT), using the newly introduced device DRX 3000^Ⱂ, in patients suffering from low back pain associated with lumbosacral disc herniation documented on MRI. Method: Thirty-five patients with low back pain with or without lower extremity radiating pain were prospectively enrolled in this study. They were all diagnosed with lumbosacral disc herniation according to physical examinations and MRI. Patients over age 60 years or those with previous spinal surgery, spondylolisthesis, severe osteoporosis, rheumatic diseases, hypertension, and other serious medical problems were excluded. Patients were randomly assigned to intermittent mechanical traction group (15 patients) or SDT group (20 patients) and compared visual analog pain scale (VAS) pre- and post-treatment. Results: There was a significant improvement in VAS in SDT group compared to intermittent mechanical traction group. The mean reduction in VAS for intermittent mechanical traction group equaled 1.93±0.83 (from 6.4±1.28 to 4.5±1.22) while the mean reduction in VAS in SDT group equaled 4.35±2.21 (from 6.9±1.86 to 2.6±1.43) (p=0.0006). Conclusion: Spinal decompression therapy can be used as an effective treatment for discogenic low back pain without serious complications. (J Korean Acad Rehab Med 2008; 32: 319-323)

2,836 View
133 Download

Comparison between the Effect of Transforaminal Steroid Injection and Transforaminal Steroid Injection Combined with Spinal Decompressor on Lumbar Disc Herniation.: Lee, Jeoung eun , Lee, Ho Jun , Hong, Young Ki , Kang, Seouk , Yoon, Bum chul , Lee, Sang Heon; J Korean Acad Rehabil Med 2007;31(5):590-595.

Abstract
PDF

Objective
To assess the short-term clinical effect of a new spinal decompression device (DRX-3000) combined with transforaminal steroid injection (TFI) in comparison with TFI only in patients with lumbar herniated intervertebral disc (HIVD) Method: Fourty-one patients diagnosed as lumbar intervertebral disc herniation were recruited and divided into two therapeutic groups. Eighteen patients were treated with DRX-3000 combined with TFI. Twenty-three patients were treated with only TFI. The visual analogue scale (VAS), straight leg rasing test (SLR), radiating pain, Oswestry Disability Index (ODI), sitting tolerance, standing tolerance and sleeping tolerance were measured before treatment and 4 weeks after treatment. Results: VAS, radiating pain, sitting tolerance and ODI were significantly improved after treatment in all patients (p＜0.05). SLR and sleeping tolerance were significantly improved in combined treatment group and standing tolerance were significantly improved in TFI group after treatment (p＜0.05). After treatment, degree of VAS decrease was larger in combined treatment group than TFI group(p＜0.05). Conclusion: Spinal decompression with TFI was more effective than only TFI in patients with lumbar HIVD in a short period. (J Korean Acad Rehab Med 2007; 31: 590-595)

1,644 View
13 Download

Gait Analysis in Cervical Spondylotic Myelopathy at Pre- and Post-Surgery.: Song, Woo Hyun , Kim, Hyeong Joon , Yoo, Jong Yoon , Sung, In Young , Rhim, Seung Chul , Yoon, Se Jin; J Korean Acad Rehabil Med 2003;27(1):58-62.

Abstract
PDF

Objective
To investigate objectively the postoperative change of the gait pattern in patients with cervical myelopathy through gait analysis.

Methods: Thirty nine patients who underwent cervical decompression and fusion for cervical myelopathy were studied. Preoperatively, gait disturbance was present in all patients. The patients were evaluated with Nurick classification, Functional Independence measure (FIM) score and gait analysis using three dimensional motion analyzer before surgery, 1 week and 3 months after surgery.

Results: In the Nurick classification there was statistically significant change but no significant change in FIM score after surgery. In the gait analysis there were statistically significant improvements in all the linear parameters, kinetic (ankle plantarflexion moment) and kinematic (knee range of motion in swing phase) parameters (p＜0.05).

Conclusion: This study suggests that gait analysis can be used as a quantitative tools of postoperative gait improvement in patient with cervical myelopathy. (J Korean Acad Rehab Med 2003; 27: 58-62)