title: Side effects and complications of automated percutaneous lumbar nucleotomy.
abstract: We reviewed the records of 243 patients treated at 271 disc levels to determine the incidence of side effects and complications of percutaneous nucleotomy. In our early experience there were 7 technical failures (2.5% of all attempts), of which 6 were at the 5th disc level. The success rate dropped from 67% at 3 months to 60% 1 year after treatment due to recurrences in 16 patients (6.6%). Extruded or sequestered fragments were found in 6 patients (2.4%), and may have been caused by nucleotomy. However, only one was accompanied by aggravation of symptoms. Discitis was seen in 2 patients (0.8%), both treated at two separate disc levels. About half the patients experienced increased low back pain, mean duration 9 days, after treatment, and 3 (1.2%), of whom 2 also had nonorganic disorders, needed admission to hospital because of severe pain. Mild spasm and a sensation of instability were noted by 9.6% and 25% of the patients respectively. Injury to nerves, bowels, vessels or ureters or a dural leak never occurred. The study confirms earlier reports that the rate of serious complications is low.
authors.affiliation: Department of Neuroradiology, Ullevaal University Hospital, Oslo, Norway.
authors.forename: R
authors.initials: R
authors.lastname: Dullerud
authors.forename: P H
authors.initials: PH
authors.lastname: Nakstad
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015299:Discitis / Q000175:diagnosis / Q000209:etiology; D017587:Diskectomy, Percutaneous / Q000295:instrumentation*; D004868:Equipment Failure; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000175:diagnosis / Q000601:surgery*; D017116:Low Back Pain / Q000209:etiology; D008159:Lumbar Vertebrae / Q000473:pathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology*; D012008:Recurrence; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed