Automatic Percutaneous Lumbar Diskectomy Combining With Chemonucleolysis In The Treatment Of Lumbar Disc Herniation

Objective: To investigate the therapeutic effect of automatic percutaneous lumbar discectomy (APLD) combining with chemonucleolysis (CNL) by injection of collagenase in the treatment of lumbar disc herniation (LDH). Methods: Forty-six patients (48 herniated lumbar discs) with LDH admitted APLD combining with chemonucleolysis from October 2002 to December 2004. There were 33 male and 13 female with an average age of 42 years (25 to70).Among them 87.5% are L_4-5, 4.2% are L_3-4L_4-5, 8.3% are L_4-5L₅-S₁. All patients operated under the TV fluoroscopy. Results: All patients were followed-up, average 15 months (ranging from 2 months to 2 years). The therapeutic effect were assessed and compared according to Hijikata's criterion, 38 operating result were marked effect (83%), six were effect (13%), 2 were ineffective (4%), effective rate is 96%. One patient was poor result associated with lumber spinal stenosis. In patient of one with L5-S1 LDH, result in fenestration discectomy posterior approach because of the difficult puncturing. Conclusion: Joint treatment has many advantages, such as short therapeutic course, fast effect, safety, high effective effect, etc. So it is an ideal method to treat lumbar disc herniation and was worth using widely.