Disc Laser Repair System For Radiculopathy Due To A Herniated Lumbar Disk

Background: The lifetime prevalence about sciatica has been reported to be 12.2%-43%.Treatment for sciatic pain ranges conservative treatment(medications and exercises)and minimally invasive surgery(Epidural steroid injection,lumbar percutaneous chemonucleolysis,Percutaneous Laser Disc Decompression)to conventional surgery.DLRS(Disc Laser Repair System)has been widely used in the treatment of sciatica,however,there is no evidence regarding the efficacy of DLRS,compared to epidural steroid injection,available to date.Objective: To determine if DLRS is more effective than epidural steroid injection in improving function and pain among patients with radiculopathy due to a herniated lumbar disc.Methods: In a parallel-group,prospective trial,we randomly assigned 94 patients in a 1:1 ratio to receive DLRS or epidural steroid injection.The primary outcomes were the Oswestry disability index(ODI)and the numeric rating scale(NRS).We also made a detailed record of adverse events and serious adverse events in both groups.Results: The DLRS groups showed an adjusted mean 2.83-point(95%CI-5.48 to-0.18,P=0.04)greater improvement in ODI scores at 8 weeks than the epidural steroid injection group and a mean 8.45-point(95%CI-12.23 to-4.66,P<0.01)at 52 weeks.Compared with the epidural steroid injection group,the DLRS group showed an adjusted mean 0.14-point(95%CI-0.72 to 0.43,P=0.63)greater reduction in pain at 8 weeks and a mean 0.7-point(95%CI-1.26 to-0.14,P=0.02)greater reduction at 52 weeks.Conclusions: Among patients with sciatica,DLRS compared with the epidural steroid injection resulted in modestly improved function and pain at 52 weeks.