Current Concepts in Intradiscal Percutaneous Minimally Invasive Procedures for Chronic Low Back Pain.
Current Concepts in Intradiscal Percutaneous Minimally Invasive Procedures for Chronic Low Back Pain.
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DOI：
10.4103/ajns.ajns_119_17
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发表时间：
2019-07-01
期刊：
影响因子：
--
通讯作者：
Korompilias, Anastasios
中科院分区：
文献类型：
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作者：
Gelalis, Ioannis;Gkiatas, Ioannis;Korompilias, Anastasios
研究设计：对热环形手术（TAPs）和经皮椎间盘减压术（PDDPs）治疗椎间盘源性慢性腰痛（CLBP）进行了系统综述。目的：本综述的目的是评价和比较TAPs和PDDPs治疗椎间盘源性CLBP的有效性，并评估与这些手术相关的并发症发生率。材料和方法：通过计算机检索PubMed数据库和已识别文章和综述论文的参考书目，识别英语期刊文章。如果经皮微创手术是CLBP患者的治疗选择，并且随访结局数据包括背痛严重程度、功能改善和/或并发症发生率的评价，则选择纳入文章。对于这篇评论，27项研究included.RESULTS：在适当选择的患者椎间盘内椎间盘切除术（IDET）程序可能会消除或延迟手术干预的需要延长一段时间，而很少有不良反应的报道。与IDET相比，关于射频瓣环成形术和椎间盘内双腔成形术有效性的文献少得多。髓核成形术是一种潜在的有效的治疗选择，患者包含椎间盘突出症，而程序是耐受性良好。经皮激光椎间盘减压术和自动经皮腰椎间盘切除术在严格选择的patients.CONCLUSIONS：这些程序可以是有效的，并可能完全不需要手术。进一步的前瞻性随机假对照试验，更高质量的证据是必要的，以确认这些程序的有效性。
STUDY DESIGN: A systemic review of thermal annular procedures (TAPs) and percutaneous disk decompression procedures (PDDPs) for the treatment of discogenic chronic low back pain (CLBP) was conducted.OBJECTIVE: The objective of this review is to evaluate and to compare the effectiveness of TAPs and PDDPs in treating discogenic CLBP and to assess the frequency of complications associated with those procedures.MATERIALS AND METHODS: English-language journal articles were identified through computerized searches of the PubMed database and bibliographies of identified articles and review papers. Articles were selected for inclusion if percutaneous minimally invasive procedures were the treatment options for patients with CLBP and if follow-up outcome data included evaluations of back pain severity, functional improvement, and/or incidence of complications. For this review, 27 studies were included.RESULTS: Intradiscal electrothermal therapy (IDET) procedure in properly selected patients may eliminate or delay the need for surgical intervention for an extended period, whereas few adverse effects have been reported. In contrast to IDET, there is far less literature on the effectiveness of radiofrequency annuloplasty and intradiscal biacuplasty procedures. Nucleoplasty is a potentially effective treatment option for patients with contained disc herniation, while the procedure is well tolerated. Increased success rates have been found for percutaneous laser disc decompression and automated percutaneous lumbar discectomy in strictly selected patients.CONCLUSIONS: These procedures can be effective and may obviate the need for surgery completely. Further prospective randomized sham-controlled trials with higher quality of evidence are necessary to confirm the efficacy of these procedures.