Lumbar Disc Herniation
Conditions
Brief summary
Recently, percutaneous endoscopic lumbar discectomy (PELD) is also commonly performed for lumbar disc herniation. Following discectomy, the relief of leg pain is common; however, the relief of back pain is less predictable. The association of back pain and lumbar disc herniation is still unclear. PELD and Annuloplasty (PELDA) can relieve back pain associated with disc herniation as well as leg pain through decompression and thermal ablation of annular defects in selected patients. Another problem that rapidly increasing go along with the growing number of microdiscectomies is directly proportional to the number of patients who undergo re-operations due to recurrences. The surgical treatment can be helpful in prevention of re-operations is nucleoplasty. Endoscopic discectomy for lumbosacral herniation supplemented with nucleoplasty can reduce the recurrence and reoperation rates.
Interventions
PROCEDUREPELDAN
percutaneous endoscopic lumbar dissectomy and annuloplasty and nucleoplasty
Sponsors
Ramathibodi Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Primary single-level lumbosacral intervertebral disc herniation at the L4-L5 or L5- S1 level will perform surgical intervention of percutaneous endoscopic lumbar discectomy * All patients present with sciatica and back pain that will not improve with conservative treatment for a minimum of 6 weeks * All patients undergo plain radiographs, magnetic resonance imaging (MRI) * The patients will require to have an obvious disc herniation that caused compression of a nerve root corresponding to the dermatomal distribution of the leg symptoms.
Exclusion criteria
* Patients have foraminal, extra-disc herniation, multilevel disc herniation, spinal stenosis, spondylolisthesis, scoliosis, prior lumbar surgery, spinal infection, spinal tumor, and a history of hip or knee arthritis.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| VAS back pain | 48 weeks |
| VAS leg pain | 48 weeks |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| ODI | 48 weeks | Oswestry disability index |
| complications | 48 weeks | Nerve injury, foot drop, dura tear |
| re-operation | 48 weeks | — |
Outcome results
None listed