Abstract
Lumbar spine disc disease has traditionally been treated surgically by laminectomy and manual removal of the offending disc material. Chymopapain was extensively used to decompress the disc pressure in a relatively noninvasive manner, but has been abandoned due to serious complications, including anaphylaxis and paraplegia. Onik introduced automated percutaneous discectomy in 1985. This procedure has proved safe and efficacious for treating lumbar disc disease without complications. It is performed on an out-patient basis under local anesthesia with minimal rehabilitation time. The success rate reported in a multi-institutional study with one year follow-up is approximately 75%. The majority of failures occur in patients with free fragments or spinal stenosis — both of which can be diagnosed preoperatively with good imaging examinations. Hence, the success rate can be expected to improve if preoperative imaging is relied upon to help choose appropriate patients. Over 30,000 percutaneous discectomy procedures have been performed. The only complication reported, disc infection, developed in fewer than 0.2% of cases. Automated percutaneous discectomy has the potential to treat a vast number of patients with lumbar disc disease who otherwise would have laminectomies.
Article PDF
Similar content being viewed by others
Explore related subjects
Discover the latest articles, news and stories from top researchers in related subjects.Avoid common mistakes on your manuscript.
References
Bocchi L, Ferrata P, Passarello F, Belloni G (1989) La nucleoaspirazione secondo Onik nel trattamento dell'ernia discale lombare analisi multicentrica dei primi risultati su oltre 650 trattamenti. Riv Neuroradiol 2:119
Davis GW (1988) Clinical experience with automated percutaneous discectomy. In: Onik G, Helms C (eds) Automated percutaneous discectomy. UCSF Radiology Research and Education Foundation, San Francisco
Davis GW, Onik G (1989) Clinical experience with automated percutaneous lumbar discectomy. Clin Orthop 238:98
Friedman WA (1983) Percutaneous discectomy. An alternative to chemonucleolysis. Neurosurgery 13:542
Hijikata S (1984) Percutaneous nuclectomy. Operation 38:507
Hijikata S (1989) Percutaneous nuclectomy: A new concept technique and 12 years' experience. Clin Orthop 238:9
Hijikata S, Yamagishi M, Nakayama T, Oomori K (1975) Percutaneous discectomy: A new treatment method for lumbar disc herniation. J Tokyo Denryoku Hospital 5:39
Hijikata S, Nakayama T, Yamagishi M, Ichihara M (1979) Percutaneous nuclectomy. Seikei Geka 11:246
Hoppenfeld S (1989) Percutaneous removal of herniated lumbar discs. 50 cases with ten-year follow-up periods. Clin Orthop 238:92
Kambin P, Gellman H (1983) Percutaneous lateral discectomy of the lumbar spine. Clin Orthop 174:127
Kambin P, Schaffer JL (1989) Percutaneous lumbar discectomy: Review of 100 patients and current practice. Clin Orthop 238:24
Maroon JC, Onik G, Sternau L (1989) Percutaneous automated discectomy: A new approach to lumbar surgery. Clin Orthop 238:64
Mink JH (1989) Imaging evaluation of the candidate for percutaneous lumbar discectomy. Clin Orthop 238:83
Monteiro A, Lefevre R, Pieters G, Wilmet E (1989) Lateral decompression of a pathological disc in the treatment of lumbar pain and sciatica. Clin Orthop 238:56
Onik G, Helms C, Ginsburg L, Hoaglund FT Morris J (1985) Percutaneous lumbar discectomy using a new aspiration probe: Porcine and cadaver model. Radiology 155:251
Onik G, Helms C, Ginsburg L, Hoaglund F, Morris J (1985) Percutaneous lumbar discectomy using a new aspiration probe. AJNR 6:290
Onik G, Maroon J, Helms C, Schweigel J, Mooney V, Kahanovitz N, Day A, Morris J, McCulloch J-A, Reicher M (1987) Automated percutaneous discectomy: Initial patient experience. Radiology 162:129
Onik G, Maroon J, Davis GW (1989) Automated percutaneous discectomy at the L5-S1 level: Use of a curved cannula. Clin Orthop 238:71
Onik G, Mooney V, Maroon J, Wiltse L, Helms C et al. (submitted for publication) Automated percutaneous discectomy: a prospective multi-institutional study
Shepperd JAN, James SE, Leach AB (1989) Percutaneous disc surgery. Clin Orthop 238:43
Stern MB (1989) Early experience with percutaneous lateral discectomy. Clin Orthop 238:50
Suezawa Y, Jacob HAC (1986) Percutaneous nucleotomy: An alternative to spinal surgery. Arch Orthop Trauma Surg 105:287
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Helms, C.A., Onik, G. & Davis, G.W. Automated percutaneous lumbar discectomy. Skeletal Radiol 18, 579–583 (1989). https://doi.org/10.1007/BF00355332
Issue Date:
DOI: https://doi.org/10.1007/BF00355332