title: The long-term efficacy and safety of percutaneous cervical nucleoplasty in patients with a contained herniated disk.
abstract: BACKGROUND
  Percutaneous cervical nucleoplasty (PCN) is a safe and effective treatment in symptomatic patients with contained cervical herniated disks. It provides simple and efficient disk decompression, using a controlled and highly localized ablation, but evidence regarding long-term efficacy is limited. We conducted a retrospective study to investigate the long-term efficacy and safety of PCN, and the influence of ideal selection settings.
  
  
  METHODS
  A total of 27 patients treated with PCN fulfilling ideal selection criteria (Group A) were studied and compared to 42 patients not meeting these criteria (Group B). Outcomes were assessed using the Visual Analogue Scale (VAS) and a four-level Likert item for perceived pain and satisfaction, the Neck Disability Index (NDI), and the Short Form 36 (SF-36). Additional relevant outcomes were retrieved from medical records.
  
  
  RESULTS
  The postoperative mean VAS pain for Group A was 29.9 (SD ± 32.6) at a mean follow-up of 24 months (range: 2-45). Only 10% of these patients reported mild transient adverse events. There was a trend, but no difference between both groups in pain scores; however, treatment satisfaction was higher for Group A (74.1 ± 27.2-55.5 ± 31.4, P = 0.02). Group A also reported better physical functioning based on the Physical Component Summary (43.6 ± 10.6-37.3 ± 12.0, P = 0.03) and showed a larger proportion of patients no longer using any medication postoperatively (63-26%, P = 0.01).
  
  
  CONCLUSIONS
  These results show long-term effectiveness and safety of PCN in patients with a one-level contained cervical herniated disk, and the reliance of selecting patients meeting ideal criteria for successful PCN.
authors.affiliation: Department of Anesthesia and Pain Management, St. Anna Hospital, Geldrop, The Netherlands. w.halim@st-anna.nl
authors.forename: Willy
authors.initials: W
authors.lastname: Halim
authors.forename: Jorgen A
authors.initials: JA
authors.lastname: Wullems
authors.forename: Toine
authors.initials: T
authors.lastname: Lim
authors.forename: Hans A
authors.initials: HA
authors.lastname: Aukes
authors.forename: Walter
authors.initials: W
authors.lastname: van der Weegen
authors.forename: Kris C
authors.initials: KC
authors.lastname: Vissers
authors.forename: Ismail
authors.initials: I
authors.lastname: Gültuna
authors.forename: Nicholas H L
authors.initials: NH
authors.lastname: Chua
mesh_terms: D000328:Adult; D002574:Cervical Vertebrae; D019299:Decompression, Surgical / Q000009:adverse effects*; D004185:Disability Evaluation; D017587:Diskectomy, Percutaneous / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome