Automated percutaneous lumbar discectomy versus chemonucleolysis in the treatment of sciatica : a randomized multicenter trial

• Published in: Spine (Philadelphia, Pa. 1976) Pa. 1976), 1993, Vol.18 (1), p.1-7
• Main Authors: REVEL, M, PAYAN, C, BEAUVAIS, C, SAVY, J. M, CHICHEPORTICHE, V, BOURGEOIS, P, SMADJA, M, HERCOT, O, WYBIER, M, CAGAN, G, BBLUM-BOISGARD, C, FERMANIAN, J, VALLEE, C, LAREDO, J. D, LASSALE, B, ROUX, C, CARTER, H, SALOMON, C, DELMAS, E, ROUCOULES, J
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; Diseases of the osteoarticular system; Diseases of the spine; Female; Follow-Up Studies; Humans; Intervertebral Disc Chemolysis; Intervertebral Disc Displacement - complications; Intervertebral Disc Displacement - surgery; Lumbar Vertebrae - surgery; Male; Medical sciences; Middle Aged; Sciatica - etiology; Sciatica - therapy; Treatment Outcome
• ISSN: 0362-2436; 1528-1159
• DOI: 10.1097/00007632-199301000-00001

A randomized clinical trial was conducted to compare the results of automated percutaneous discectomy with those of chemonucleolysis in 141 patients with sciatica caused by a disk herniation; 69 underwent automated percutaneous discectomy and 72 were subjected to chemonucleolysis. The principle outcome was the overall assessment of the patient 6 months after treatment. Treatment was considered to be successful by 61% of the patients in the chemonucleolysis group compared with 44% in the automated percutaneous discectomy group. At 1-year follow-up, overall success rates were 66% in the chemonucleolysis group and 37% in the automated percutaneous group. Within 6 months of treatment, 7% of the patients in the chemonucleolysis group and 33% in the discectomy group underwent subsequent open surgery. The complication rates of both treatment groups were low, with the exception of a high rate of low-back pain in the chemonucleolysis group (42%). The results of this trial confirm previous controlled studies on chemonucleolysis and suggest that controlled studies should be carried out before automated percutaneous discectomy can be considered a useful intervention.