Comparative prospective randomized study comparing conservative treatment and percutaneous disk decompression for treatment of intervertebral disk herniation

Radiology. 2011 Aug;260(2):487-93. doi: 10.1148/radiol.11101094. Epub 2011 May 25.

Abstract

Purpose: To compare short-, intermediate-, and long-term functional results concerning pain reduction and mobility improvement between conservative therapy and percutaneous disk decompression (PDD) in patients with intervertebral disk herniations.

Materials and methods: The study received approval from both the university ethics panel and the institutional review board. Patients provided informed consent for the study. Over the past 4 years, two randomized groups of 31 patients with sciatica due to intervertebral disk herniation were prospectively studied and compared with the t test. The control group underwent conservative therapy (administration of analgesics, antiinflammatory drugs, muscle relaxants, and physiotherapy) for 6 weeks. The decompression group underwent fluoroscopically guided PDD. Pain reduction and mobility improvement were recorded at 3-, 12-, and 24-month follow-up on a numeric visual scale (NVS) (range, 0-10).

Results: The control group had a mean pain score of 6.9 NVS units ± 1.9 prior to conservative therapy. This was reduced to 0.9 NVS units ± 2.0 3 months after therapy; however, it increased to 4.0 NVS units ± 3.4 at 12-month follow-up and further increased to 4.0 NVS units ± 3.4 at 24-month follow-up. The decompression group had a mean pain score of 7.4 NVS units ± 1.4 prior to PDD. This was reduced to 3.0 NVS units ± 2.4 at 3-month follow-up and further reduced to 1.7 NVS units ± 2.4 at 12-month follow-up and 1.6 NVS units ± 2.5 at 24-month follow-up. No complications were noted.

Conclusion: When compared with conservative therapy, PDD shows improved amelioration of symptoms at 12- and 24-month follow-up.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Analgesics / therapeutic use
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Decompression, Surgical
  • Female
  • Humans
  • Intervertebral Disc Displacement / surgery
  • Intervertebral Disc Displacement / therapy*
  • Magnetic Resonance Imaging
  • Male
  • Neuromuscular Agents / therapeutic use
  • Pain Measurement
  • Physical Therapy Modalities
  • Prospective Studies
  • Treatment Outcome

Substances

  • Analgesics
  • Anti-Inflammatory Agents, Non-Steroidal
  • Neuromuscular Agents