Study of Automated Percutaneous Lumbar Discectomy for Lumbar Disc Herniation.

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We report our clinical results from 105 patients who were treated with automated percutaneous lumbar discectomy (APLD) for lumbar disc herniation. Average improvement rate of JOA scores for all types of lumbar disc herniations treated by APLD was 83.2%. When the herniations were classified into 3 types primarily based on the discogram, the average improvement rates were 93.7%, 83.7%, and 71.4% for protrusions, subligamentous extrusions, and transligamentous extrusions, respectively.We further subclassified subligamentous extrusion type herniations into S1 and S2, and transligamentous extusion type herniations into T1, T2 and T3. The descriptions of each are as follows. S1: The pulpy nucleus extrudes at the disc level. S2: The pulpy nucleus extrudes 5mm above or below the edge of the vertebra. T1: The PLL is ruptured, but the center of the herniation is within the PLL. T2: The center of the herniation is outside of the PLL at the disc level. T3: The center of the herniation is under the PLL, but the pulpy nucleus extrudes 5mm above or below the edge of the vertebra.Categorized in this way the average improvement rates of JOA score were 88.5%, 61.5%, 89.3%, 18.8%, and 71.0% for S1, S2, T1, T2, and T3, respectively.Therefore, S1, T1 and T3 type herniations are suitable for APLD, but S2 and T2 type herniations are not.
中国・四国整形外科学会の論文