Percutaneous lumbar discectomy: a systematic review

Authors

  • Marcelo Ferraz de Campos a Centro Universitário Faculdade de Medicina do ABC, São Caetano do Sul, SP-Brasil. b Hospital Heliópolis, Departamento de Neurocirurgia. São Paulo, SP- Brasil.
  • Thiago Salatii a Centro Universitário Faculdade de Medicina do ABC, São Caetano do Sul, SP-Brasil.
  • José Carlos Rodrigues Junior a Centro Universitário Faculdade de Medicina do ABC, São Caetano do Sul, SP-Brasil.
  • Ricardo Maximo Grecco a Centro Universitário Faculdade de Medicina do ABC, São Caetano do Sul, SP-Brasil.
  • Ingrid Soares de Souza a Centro Universitário Faculdade de Medicina do ABC, São Caetano do Sul, SP-Brasil.
  • Agatha Mesaroch a Centro Universitário Faculdade de Medicina do ABC, São Caetano do Sul, SP-Brasil.
  • Naomi Rodrigues Andrade c Universidade de Franca, Franca, SP-Brasil.
  • Yasmin Matos Araújo Silva c Universidade de Franca, Franca, SP-Brasil.
  • Cynthia A. Kallas Bachur c Universidade de Franca, Franca, SP-Brasil.
  • José Alexandre Bachur c Universidade de Franca, Franca, SP-Brasil.

DOI:

https://doi.org/10.36311/jhgd.v33.14187

Keywords:

low back pain, degenerative disc disease, disc decompression

Abstract

Introduction: low back pain is a clinical condition with a multifactorial etiopathogenesis, which has a high socioeconomic impact, especially in the economically active population, as it is associated with frequent absenteeism and reduced quality of life. Through intervertebral disc degeneration, a progressive instability of the compromised region is observed, triggering a harmful positive feedback mechanism that further promotes intervertebral disc disease. Built by the interaction between the predisposing biopsychosocial components, a multidisciplinary therapeutic proposition is suggested. In persistent low back pain, treatment involves surgical procedures such as Percutaneous Lumbar Discectomy.

Objective: to evaluate the scientific evidence regarding the clinical outcomes and safety of this surgery.

Methods: systematic review duly registered in Prospero (CRD42022370811), based on the PICOD question, elaborated from a Boolean search in different databases for scientific articles, evaluated and selected in a paired way based on the eligibility criteria. In addition to extracting data related to the proposed objectives, the articles included were evaluated in relation to their level of evidence and strength of recommendation.

Results: among the 12 articles included, it was observed that it is a clinically effective and safe procedure. In the set of evidences gathered, they are of high and moderate level of evidence with respective strength of recommendation strong/good and weak/moderate.

Conclusion: Percutaneous Lumbar Discectomy promotes significant reduction of pain and increase in body functionality, in addition to preserving local musculoskeletal structures and preventing post-surgical joint instability. It is, therefore, a safe and clinically effective minimally invasive procedure for patients with herniated discs.

References

Russo F, Di Tecco C, Fontana L., Adamo G, Papale A, Denaro V, Iavicoli S. Prevalence of Work Related Musculoskeletal Disorders in Italian Workers: Is There an Underestimation of the Related Occupational Risk Factors?. BMC Musculoskelet. Disord. 2020;21:738. doi: 10.1186/s12891-020-03742-z.

Instituto Brasileiro de Geografia e Estatística. Pesquisa Nacional por Amostra de Domicílios. Um panorama da saúde no Brasil: acesso e utilização dos serviços, condições de saúde e fatores de risco e proteção à saúde, 2008. Rio de Janeiro: Instituto Brasileiro de Geografia e Estatística; 2010. ISBN:9788524041129.

Caminhante BF. A prevalência de dor lombar: uma revisão sistemática da literatura de 1966 a 1998. Cirurgia Clínica da Coluna. 2000; 13( 3 ): 205-217.

Weiner DK, Sakamoto S, Perera S, Breuer P. Chronic low back pain in older adults: prevalence, reliability, and validity of physical examination findings. J Am Geriatr Soc. 2006;54(1):11-20.

Maetzel A, Li L. The economic burden of low back pain: a review of studies published between 1996 and 2001. Best Pract Res Clin Rheumatol 2002; 16:23-30.

Rizzo JA, Abbott TA 3rd, Berger ML. The labor productivity effects of chronic backache in the United States. Med Care. 1998;36(10):1471-88. doi: 10.1097/00005650-199810000-00006. PMID: 9794341.

Maniadakis N, Gray A. The economic burden of back pain in the UK. Pain. 2000;84(1):95-103. doi: 10.1016/S0304-3959(99)00187-6. PMID: 10601677.

Knezevic NN, Candido KD, Vlaeyen JWS, Zundert JV, Cohen SP. Low back pain. The Lancet 2021;398:78–92. DOI: https://doi.org/10.1016/S0140-6736(21)00733-9.

Junior MH, GOLDENFUM MA, SIENA C. Lombalgia Ocupacional. Rev Assoc Med Bras. 2010;56(5):583-589.

Imagama S, Matsuyama Y, Hasegawa Y, et al. A força muscular das costas e a mobilidade da coluna vertebral são preditores de qualidade de vida em homens de meia-idade e idosos . Eur Spine J. 2011;20:954-961.

Reid S, Hazard RG, Fenwick JW. Déficits isocinéticos de força do tronco em pessoas com e sem dor lombar: um estudo comparativo com consideração de esforço. J Distúrbio da Coluna. 1991; 4:68-72.

Masni-Azian, Tanaka M. Biomechanical investigation on the influence of the regional material degeneration of an intervertebral disc in a lower lumbar spinal unit: A finite element study. Computers in Biology and Medicine 2018;98:26–38. https://doi.org/10.1016/j.compbiomed.2018.05.010

Lotz JC, Colliou OK, Chin JR, Duncan NA, Liebenberg E. Compression-induced degeneration of the intervertebral disc: an in vivo mouse model and finite-element study. Spine (Phila Pa 1976) 1998;23:2493–506.

Videman T, Leppävuori J, Kaprio J, Battié MC, Gibbons LE, Peltonen L, et al. Polimorfismos intragênicos do gene do receptor da vitamina D associados à degeneração do disco intervertebral. Spine (Phila Pa 1976) 1998;23:2477-85. doi: https://doi.org/10.1097/00007632-199812010-00002

Battié MC, Videman T, Parent E. Lumbar disc degeneration: epidemiology and genetic influences. Spine (Phila Pa 1976) 2004;29:2679–90. doi:https://doi.org/10.1097/01.brs.0000146457.83240.eb

Swärd L, Hellström M, Jacobsson B, Nyman R, Peterson L. Disc degeneration and associated abnormalities of the spine in elite gymnasts. A magnetic resonance imaging study. Spine (Phila Pa 1976) 1991;16:437–43. doi: https://doi.org/10.1097/00007632-199104000-00009

Muresanu C, Somasundaram SG, Neganova ME, Bovina EV, Vissarionov SV, Ofodile ONFC, et al. Updated Understanding of the Degenerative Disc Diseases - Causes Versus Effects - Treatments, Studies and Hypothesis. Curr Genomics 2020;21:464–77. https://doi.org/10.2174/1389202921999200407082315

Muftic M, Miladinovic K. Therapeutic ultrasound and pain in degenerative diseases of musculoskeletal system. Acta Inform Med 2013;21:170–2. https://doi.org/10.5455/aim.2013.21.170-172.

Aprile BC, Amato MCM, Oliveira CA. Functional Evolution after Percutaneous Endoscopic Lumbar Discectomy, na Earlier Evaluation of 32 Cases. Rev. Brasileira de Ortopedia. 2020;55(04):415-418. DOI: 10.1055/s-0039-3402473.

Facure JJ. Discectomia percutânea a laser. Arq Bras Neurocir. 2000;19(1):8–13.

Kim K, Isu T, Morimoto D, Iwamoto N, Kokubo R, Matsumoto J, Kitamura T, Sugawara A, Morita A. Comon diseases mimicking lumbar disc herniation and their treatment. Mini-invasive Surg. 2017;1:43-51. DOI: 10.20517/2574-1225.2017.05

Sani TSA, Harrad D. Principais itens para relatar Revisões sistemáticas e Meta-análises: A recomendação PRISMA. Epidemiologia e Serviços de Saúde, 2015; 24(2):335-342.

Santos CMC, Pimenta CAM, Nobre MRC. A estratégia PICO para a construção da pergunta de pesquisa e busca de evidências. Rev Latino-am Enfermagem. 2007; 15(3). https://doi.org/10.1590/S0104-11692007000300023.

Kranke P. Evidence-based pratice: know to perform and use systematic reviews for clinical decision-making. Eur J Abaestrhsiol. 2010;27:763-72.

Mancini MC, Cardoso JR, Sampaio RF, et al. Tutorial para elaboração de revisões sistemáticas para o Brazilian Journal of Physical Therapy. Braz J Phys Ther. 2014;18:471-80.

Barbosa FT, Lira AB, Neto OBO, et al. Tutorial para execução de revisões sistemáticas e metanálises com estudos de intervenção em anestesia. Rev Bras Anestesiol. 2019;69(3):299-306.

Roever L. Understanding systematic review studies. Rev Soc Bras Clin Med. 2017;15(2):127-30.

Pacheco RL, Latorraca COC, Martimbianco ALC, Pachito DV, Riera R. PROSPERO: base de registro de protocolos de revisões sistemáticas. Estudo descritivo. Diagn Tratamento. 2018;23(3):101-4.

Donato H, Donato M. Etapas na condução de uma revisão sistemática, Acta Med Port 2019;32(3):227-235.

Mourad Ouzzani M, Hammady H, Fedorowicz Z, and Elmagarmid A. Rayyan - a web and mobile app for systematic reviews. Systematic Reviews. 2016;5:210. DOI: 10.1186/s13643-016-0384-4

National Health and Medical Research Council. A guide to the development, implementation and evaluation of clinical practice guidelines. Commonwealth of Australia, 1999. ISBN 1864960485.http://www.ausinfo.gov.au/general/gen_hottobuy.htm

Oxford Centre for Evidence-based Medicine: levels of evidence (2009) https://www.cebm.ox.ac.uk/resources/levels-of-evidence/ocebm-levels-of-evidence.

Grade Working Group. (2013). Grade. https://www.gradeworkinggroup.org/.

Kim M, Lee S, Kim H-S, Park S, Shim S-Y, Lim D-J. A Comparison of Percutaneous Endoscopic Lumbar Discectomy and Open Lumbar Microdiscectomy for Lumbar Disc Herniation in the Korean: A Meta-Analysis. BioMed Research International. 2018;2018:e9073460.DOI: 10.1155/2018/9073460

Andersson GB, Brown MD, Dvorak J, Herzog RJ, Kambin P, Malter A, et al. Consensus summary of the diagnosis and treatment of lumbar disc herniation. Spine. 1996;21(24l):75S-78S. DOI: 10.1097/00007632-199612151-00009

S. Ruetten, M. Komp, H. Merk e G. Godolias, “Recurrent lombar disc herniation after convencional discectomy: a prospect, random study comparando full-endoscopic interlaminar and transforaminal versus microsurgical revision”, Journal of Spinal Disorders & Techniques. 2009;22(2):122–129.

Lee MY, Boudier-Revéret M, Cho HK, Chand MC. The successful treatment of Herniated Lumbar Discs that are refractory to repeated edpidural steroid injection by using a navigable percutaneous disc decompression device: a case series. Journal of Pain Research. 2020;13:1869-1873.

Kim JY, Lee KS, Jung SM, Kim YH. Prognostic factors for successful percutaneous disc decompression usin the navigable device L’DISQ in patients with lumbar discogenic pain. Pain Physician. 2022;25:E157-E164.

Gobin P, Theron J, Courtheoux F, Huet H, Chos D, Loyau G. Percutaneous automated lumbar nucleotomy. J Neuroradiol. 1989;16(3):203-13.

Fiume D, Parziale, Rinaldi A, Sherkat S. Automated percutaneous discectomy in herniated lumbar discs treatment: experience after the first 200 cases. J Neurosurg Sci. 1994;38(4):235-7.

Haines SJ, Jordan N, Boen JR, Nyman JA, Oldridge NB, Lindgren BR. Discectomy strategies for lumbar disc herniation: results of the LAPDOG trial. J Clin Neurosci. 2002;9(4):411-7. doi: 10.1054/jocn.2002.1120.

Amoretti N, David P, Grimaud A, Flory P, Hovorka I, Roux C, Chevallier P, Bruneton JN. Clinical follow-up of 50 patients treated by percutaneous lumbar discectomy. Clin Imaging. 2006;30(4):242-4. doi: 10.1016/j.clinimag.2006.01.019.

Kotil K, Akcetin M, Bilge T. A minimally invasive transmuscular approach to far-lateral L5-S1 level disc herniations: a prospective study. J Spinal Disord Tech. 2007;20(2):132-8. doi:10.1097/01.bsd.0000211268.43744.2a.

Mirzai H, Tekin I, Yaman O, Bursali A. The results of nucleoplasty in patients with lumbar herniated disc: a prospective clinical study of 52 consecutive patients. Spine J. 2007;7(1):88-93. doi: 10.1016/j.spinee.2006.02.033.

Zhu H, Zhou XZ, Cheng MH, Shen YX, Dong QR. The efficacy of coblation nucleoplasty for protrusion of lumbar intervertebral disc at a two-year follow-up. Int Orthop. 2011;35(11):1677-82. doi: 10.1007/s00264-010-1196-0.

Revel M, Payan C, Valee C, Laredo JD, LAssale B, Roux C, Carter H, Salomon C, Delmas E, Roucoules J, et al. Automated percutaneous lumbar discectomy versus chemonucleolysis in the treatment of sciatica. A randomized multicenter trial. Spine. 1993; 18(1):1-7. doi: 10.1097/00007632-199301000-00001.

Moon CT, Cho J, Chang SK. Availability of discographic computed tomography in automated percutaneous lumbar discectomy. J Korean Med Sci. 1995;10(5):368-72. doi: 10.3346/jkms.1995.10.5.368.

Teng GJ, Jeffery RF, Guo JH, He SC, Zhu HZ, Wang XH, Wu JM, Ling XL, Qian Y, Zhng YM, Zhu MJ, Guan L, He XM. Automated percutaneous lumbar discectomy: a prospective multi-institutional study. J Vasc Interv Radiol. 1997;8(3):457-63. doi.org/10.1016/S1051-0443(97)70589-X

Wu CG, Li YD, Li MH, Gu YF, Ji BQ, Li M. Transabdominal percutaneous L5 S1 lumbar discectomy: interventional technique, early results, and complications. J Vasc Interv Radiol. 2007;18(9):1162-8. doi: 10.1016/j.jvir.2007.06.008.

Wu Z, Wei LX, Li J, Wang Y, Ni D, Yang P, Zhang Y. Percutaneous treatment of non-contained lumbar disc herniation by injection of oxygen-ozone combined with collagenase. Eur J Radiol. 2009;72(3):499-504. doi: 10.1016/j.ejrad.2008.07.029.

Fasoli F, Gandini R, Scaggiante J, Bartolo M, Capobianco SV, Cerone G. Minimally-invasive percutaneous treatments for low back pain and leg pain: a radomized controlled study of termal disc decompression versus mechanical percutaneous disc decompression. The Spine Journal. 2022;22:709-715. DOI: 10.1016/j.spinee.2021.12.008

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Published

2023-03-23

Issue

Vol. 33 No. 1 (2023)

Section

ORIGINAL ARTICLES

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Copyright (c) 2023 Campos MFC, Salatii T, Junior JCR, Grecco RM, Souza IS, Mesaroch A, Andrade NR, Silva YMA, Bachur CAK, Bachur JA.

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