게시판
| 21KS-005 |
Predictive factors of successful L’DISQ in patient with lumbar discogenic pain
Department of Anesthesiology and Pain Medicine, Seoul St. Mary s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Department of Anesthesiology and Pain Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea 1
Background : A navigable percutaneous disc decompression device (L’DISQ) have shown to be effective and safe in several clinical reports for the treatment of lumbar discogenic pain. There was no paper has reported prognostic factors of the procedure.
Objectives : To present prognostic factors associated with the successful outcome of percutaneous disc decompression (PDD) using the L’DISQ when treating lumbar discogenic pain
Method : L’DISQ was performed under fluoroscopic guidance by single physican (Y.H.K). Patients were followed up at pre-procedure, and one month, 2, 3, and 6 months after the procedure. Successful outcome was defined as 50% or greater reduction of the numeric rating scale for pain (NRS pain), and 40% or more reduction of the Oswestry disability index (ODI) after 6 months of the procedure. Clinical parameters including patient demographics, pain duration, history of surgery, the number of levels of the procedure, and the radiographic finding of the lumbar magnetic resonance imaging (e.g., unilateral or bilateral herniated disc, migration of herniated disc, broadly herniated disc, decreased brightness of disc in T2-weighted MRI image, high intensity zone (HIZ), central stenosis, foraminal stenosis, thecal sac compression, and spondylolisthesis) were examined
Result : Of 106 patients, 80 (75.5%) patients had successful results at 6 months after the procedure compared with baseline. Multivariable logistic regression analysis revealed that HIZ (P = 0.016) was independent positive predictor of successful PDD outcomes; conversely, migration of herniated disc (P = 0.017) and bilaterally herniated disc (P = 0.001) were negative predictors.
Conclusion : In this study, L’DISQ was found to be safe and effective for lumbar discogenic pain relief. Success rate was 75.5% without any severe complication. Presence of HIZ, absence of migration of herniated disc, unilaterally herniated disc were positive predictors of successful procedure.
Reference
- Lee, S. H. et al. Efficacy of a new navigable percutaneous disc decompression device (L\'DISQ) in patients with herniated nucleus pulposus related to radicular pain. Pain Med 12, 370-376 (2011).
- Kloth, D. S., Fenton, D. S., Andersson, G. B. & Block, J. E. Intradiscal electrothermal therapy (IDET) for the treatment of discogenic low back pain: patient selection and indications for use. Pain Physician 11, 659-668 (2008).
Objectives : To present prognostic factors associated with the successful outcome of percutaneous disc decompression (PDD) using the L’DISQ when treating lumbar discogenic pain
Method : L’DISQ was performed under fluoroscopic guidance by single physican (Y.H.K). Patients were followed up at pre-procedure, and one month, 2, 3, and 6 months after the procedure. Successful outcome was defined as 50% or greater reduction of the numeric rating scale for pain (NRS pain), and 40% or more reduction of the Oswestry disability index (ODI) after 6 months of the procedure. Clinical parameters including patient demographics, pain duration, history of surgery, the number of levels of the procedure, and the radiographic finding of the lumbar magnetic resonance imaging (e.g., unilateral or bilateral herniated disc, migration of herniated disc, broadly herniated disc, decreased brightness of disc in T2-weighted MRI image, high intensity zone (HIZ), central stenosis, foraminal stenosis, thecal sac compression, and spondylolisthesis) were examined
Result : Of 106 patients, 80 (75.5%) patients had successful results at 6 months after the procedure compared with baseline. Multivariable logistic regression analysis revealed that HIZ (P = 0.016) was independent positive predictor of successful PDD outcomes; conversely, migration of herniated disc (P = 0.017) and bilaterally herniated disc (P = 0.001) were negative predictors.
Conclusion : In this study, L’DISQ was found to be safe and effective for lumbar discogenic pain relief. Success rate was 75.5% without any severe complication. Presence of HIZ, absence of migration of herniated disc, unilaterally herniated disc were positive predictors of successful procedure.
Reference
- Lee, S. H. et al. Efficacy of a new navigable percutaneous disc decompression device (L\'DISQ) in patients with herniated nucleus pulposus related to radicular pain. Pain Med 12, 370-376 (2011).
- Kloth, D. S., Fenton, D. S., Andersson, G. B. & Block, J. E. Intradiscal electrothermal therapy (IDET) for the treatment of discogenic low back pain: patient selection and indications for use. Pain Physician 11, 659-668 (2008).
