Utilidad de la herniectomía y discectomía percutánea guiada por tomografía computarizada

Abstract

The main objective of this study is to evaluate the efficacy of CT- and fluoroscopy-guided percutaneous herniectomy. It is a new type of alternative treatment to surgery, and in our case, we have evaluated the treatment for patients with radicular pain caused by lumbar disc herniation that showed no improvement after conservative medical treatment._x000D_ For the evaluation of the effectiveness and viability of this technique we have assessed 132 patients with herniated disc radicular pain, and with no improvement with conservative medical treatment correctly performed. The study seeks to go beyond measuring the evolution of pain in each patient, also characterizing the evolution of their quality of life and their functional capacity. The VAS score scale is used to measure pain, the EuroQol-5D-3L (EQ) is used for quality of life assessment, and the Oswestry Disability Index (ODI) is used for functional capacity evaluation._x000D_ The different evaluations were applied in the initial consultation, after the treatment, and with a follow-up at one month, 3 months, 6 months and 12 months after the intervention. Statistical analysis shows a significant decrease in pain measured through the VAS, as well as a significant improvement in quality of life and functional capacity (measured by the EQ and ODI) compared to the initial determination. This improvement in the different dimensions is not only persistent but is also progressive in the follow-up time, which is related to the minimal aggressiveness of the technique._x000D_ Quality of life and functional capacity measurement provide a more detailed evaluation of the effects of the treatment. For example, a particularly marked generalized improvement in the anxiety / depression dimension stands out, which we also interpret as a consequence of a treatment that leaves minimal sequelae in the patient. Our study concludes that CT- and fluoroscopy-guided percutaneous herniectomy and discectomy is an effective and safe treatment of lumbar radicular syndrome refractory to conservative treatment, that can be performed instead of surgery, limiting spinal surgery to cases that do not progress favorably.

Date of Award	20 Apr 2021
Original language	Spanish
Supervisor	García Vila José Hermenegildo (Director)