medigraphic.com

2011, Número 2

<< Anterior Siguiente >>

Rev Med Inst Mex Seguro Soc 2011; 49 (2)


Discectomía percutánea para tratamiento del dolor radicular

Delgado-Álvarez JC, Tamayo-Valenzuela AC, Pérez-Carranco ML, Villafaña-Tello JJS

Idioma: Español
Referencias bibliográficas: 44
Paginas: 147-152
Archivo PDF: 124.96 Kb.


RESUMEN

Introducción: la discectomía percutánea ha mostrado ser útil para el dolor radicular por hernia de disco. El objetivo de esta investigación fue evaluar la efectividad de la discectomía percutánea en el dolor radicular por hernias de disco.
Métodos: se analizaron expedientes de pacientes sometidos a discectomía percutánea de enero de 2006 a diciembre de 2008; se incluyeron expedientes que tuvieron registrada la intensidad del dolor determinada por la Escala Visual Análoga (EVA) y el consumo de analgésicos (en mg) por día, antes y después del procedimiento. Los miligramos del analgésico empleado se convirtieron a dosis equivalente en morfina oral en 24 horas. Se comparó la intensidad del dolor y el consumo de medicamentos antes y después del procedimiento.
Resultados: la puntuación promedio de la EVA previa al procedimiento fue de 6.29 y posterior a éste, de 2.86. La media de medicamentos consumidos antes de la discectomía fue de 30.32 y posterior al procedimiento, de 12.75.
Conclusiones: identificamos mejoría del dolor en un porcentaje elevado de pacientes, que se reflejó en disminución de la calificación en EVA y en el consumo de analgésicos.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. Domsky R, Goldberg ME, Hirsh RA, Scaringe D, Torjman MC. Critical failure of a percutaneous discectomy probe requiring surgical removal during disc decompression. Reg Anesth Pain Med 2006;31(2):177-179.

  2. Gun C, Lee SH, Bhanot A, Raiturker PP, Chae YS. Percutaneous endoscopic discectomy for extraforaminal lumbar disc herniations. Spine 2007;15;32(2):E93-E99.

  3. Righesso O, Falavigna A, Avanzi O. Comparison of open discectomy with microendoscopic disectomy in lumbar disc herniations. Neurosurgery 2007;61(3):545-549; discussion 549.

  4. Xie J, Hurlbert RJ. Discectomy versus discectomy with fusion versus disectomy with fusion and instrumentation. Neurosurgery 2007;61(1):107-16; discussion 116-7.

  5. Lee S, Kang BU, Ahn Y, Choi G, Choi YG, Ahn KU, et al. Operative failure of percutaneous endoscopic lumbar discectomy: a radiologic analysis of 55 cases. Spine 2006; 31(10):E285-E290.

  6. Wu X, Zhuang S, Mao Z, Chen H. Microendoscopic discectomy for lumbar disc herniation surgical technique and outcome in 873 consecutive cases. Spine 2006;31 (23):2689-2694.

  7. Koes B, Tulder V. Diagnosis and treatment of low back pain. BMJ 2006;332(7555):1430-1434. 8. Gun C, Lee SH, Raiturker PP, Lee S, Chae YS. Percutaneous endoscopic interlaminar discectomy for intracanalicular disc herniations at L5-S1 using a rigid working channel endoscope. Neurosurgery 2006;58(1 Suppl):S59-S68.

  8. Aló K M, Wright RE, Sutcliffe J, Brandt SA. Percutaneous lumbar discectomy: clinical response in an initial cohort of fifty consecutive patients with chronic radicular pain. Pain Pract 2004(1);4:19-29.

  9. Aló KM, Wrigh RE, Sutcliffe J, Brandt SA. Percutaneous lumbar discectomy: one-year follow-up in an initial cohort of fifty consecutive patients with chronic radicular pain. Pain Pract 2005;5( 2):116-124.

  10. Ruetten S, Komp M, Merk H, Godolias G. Full-endoscopic interlaminar and transforaminal lumbar discectomy versus conventional microsurgical technique. Spine 2008; 33(9):931-939.

  11. 12 Amoretti N, David P, Grimaud A, Flory P, Hovorka I, Roux Ch, et al. Clinical follow-up of 50 patients treated by percutaneous lumbar discectomy. Clin Imaging 2006;30(4):242-244.

  12. Stewart T, Schlenk RP, Benzel EC. Multiple level discectomy and fusion. Neurosurgery 2007;60(1 Supp1 1):S143-S148.

  13. Ahn Y, Lee SH, Park WM, Lee HY, Shin SW, Kang HY. Percutaneous endoscopic lumbar discectomy for recurrent disc herniation: surgical technique, outcome, and prognostic factors of 43 consecutive cases. Spine 2004;29(16): E326- E332.

  14. Peng B, Wu W, Hou S, Li P, Zhang C, Yang Y. The pathogenesis of discogenic low back pain. J Bone Joint Surg Br 2005;87(1):62-67.

  15. Watkins R, Williams LA, Watkins RG. Microscopic lumbar discectomy results for 60 cases in professional and Olympic athletes. Spine J 2003;3(2):100-105.

  16. Tsou PM, Yeung ChA, Yeung AT. Posterolateral transforaminal selective endoscopic discectomy and thermal annuloplasty for chronic lumbar discogenic pain: a minimal access visualized intradiscal surgical procedure. Spine J 2004;4(5):564-573.

  17. Hoogland T, Brekel-Dijkstra KV, Schubert M, Miklitz B. Endoscopic transforaminal discectomy for recurrent lumbar disc herniation. Spine 2008;33(9):973-978.

  18. Zheng Y, Liew SM, Simmons ED. Value of magnetic resonance imaging and discography in determining the level of cervical discectomy and fusion. Spine 2004;29 (19):2140-2145.

  19. Tosteson A, Skinner JS, Tosteson TD, Lurie JD, Andersson GB, Berven S, et al. The cost effectiveness of surgical versus nonoperative treatment for lumbar disc herniation over two years. Spine 2008;33(19):2108-2115.

  20. Hurri H, Karppinen J. Discogenic pain. Pain 2004;112 (3):225-228.

  21. Österman H, Seitsalo S, Karppinen J, Malmivaara A. Effectiveness of microdiscectomy for lumbar disc herniation. Spine 2006;31(21):2409–2414.

  22. Ozer A, Oktenoglu T, Sasani M, Bozkus H, Canbulat N, Karaarslan E, et al. Preserving the ligamentum flavum in lumbar discectomy: a new technique that prevents scar tissue formation in the first 6 months postsurgery. Neurosurgery 2006;59(1 Suppl 1)::ONS126-ONS133.

  23. Amoretti N, Huchot F, Flory P, Brunner P, Chevallier P, Bruneton JN. Percutaneous nucleotomy: preliminary communication on a decompression probe (Dekompressor) in percutaneous discectomy. Ten case reports. Clin Imaging 2005;29(2):98-101.

  24. Keshari K, Lotz J, Link T, Hu S, Majumdar S, Kurhanewicz J. Lactic acid and proteoglycans as metabolic markers for discogenic back pain. Spine 2008;33(3):312-317.

  25. Kapural L, Cata J. Complications of percutaneous techniques used in the diagnosis and treatment of discogenic lower back pain. Tech Reg Anesth Pain Manag 2007;11: 157-163.

  26. Smeal W, Tyburski M, Alleva J. Discogenic/radicular pain. Dis Mon 2004;50(12):636-669.

  27. Schaufele M, Hatch L, Jones W. Interlaminar versus transforaminal epidural injections for the treatment of symptomatic lumbar intervertebral disc herniations. Pain Physician 2006;9(4):361-366.

  28. Urrutia G, Kovacs F, Nishishinya M. Percutaneous thermocoagulation intradiscal techniques for discogenic low back pain. Spine 2007; 32(10):1146-1154.

  29. Wasana A, Davarb G, Jamison R. The association between negative affect and opioid analgesia in patients with discogenic low back pain. Pain 2005;117(3):450-461.

  30. Kapural L, Goyle A. Imaging for provocative discography and minimally. Invasive percutaneous procedures for treatment of discogenic lower back pain. Tech Reg Anesth Pain Manag 2007;11:73-80.

  31. Zhou Y, Abdi S. Diagnosis and minimally invasive treatment of lumbar discogenic pain –a review of the literature. Clin J Pain 2006;22(5):468-481.

  32. Fardon D, Milette P. Nomenclature and classification of lumbar. Spine 2001,26(5):E93-E113.

  33. Hayashi S, Taira A, Inoue G, Koshi T, Ito T, Yamashita M, et al. TNF-alpha in nucleus pulposus induces sensory nerve growth. Spine 2008;33(14):1542-1546.

  34. Lima Ch, Jeea W, Sonb B, Kimb D, Hac K, Parkb Ch. Discogenic lumbar pain: association with MR imaging and CT discography. Eur J Radiol 2005;54(3):431-437.

  35. Khot A, Bowditch M, Powell J, Sharp D. The use of intradiscal steroid therapy for lumbar spinal discogenic pain. A randomized controlled trial. Spine 2004;29(8):833-837.

  36. Carragee E, Lincoln T, Parmar V, Alamin T. A Gold standard evaluation of the “discogenic pain” diagnosis as determined by provocative discography. Spine 2006;31 (18):2115-2123.

  37. Gajraj N. Selective nerve root blocks for low back pain and radiculopathy. Reg Anesth Pain Med 2004;29(3):243-256.

  38. Bach G, Lim R. Minimally invasive spine surgery for low back pain. Dis Mon 2005;51(1):34-57.

  39. Kulcu D, Naderi S. Differential diagnosis of intraspinal and extraspinal non-discogenic sciatica. J Clin Neurosci 2008; 15(11):1246-1252.

  40. Carragee E, Todd F, Alamin F. Discography: a review. Spine J 2001;1(5):364-372.

  41. Cohen S, Larkin T, Barna S, Palmer W, Hecht A, Stojanovic M. Lumbar discography: a comprehensive review of outcome studies, diagnostic accuracy, and principles. Reg Anesth Pain Med 2005;30(2):163-183.

  42. Freynhagen R, Rolke R, Baron R, Tolle T, Rutjes AK, Schu S, et al. Pseudoradicular and radicular low-back pain – A disease continuum rather than different entities? Answers from quantitative sensory testing. Pain 2008;135(1-2):65-74.

  43. Cuellar J, Golish R, Reuter M, Cuellar V, Angst M, Carragee E, et al. Cytokine evaluation in individuals with low back pain using discographic lavage. Spine J 2010;10(3):212-218.

  44. Derby R, Baker R, Lee Ch. Evidence-informed management of chronic low back pain with minimally invasive nuclear decompression. Spine J 2008;8(1):150-159.




2020     |     www.medigraphic.com