Percutaneous Lumbar Disc Cut Suction Combined With Collagenase Dissolution Treatment Of Lumbar Disc Herniation

Objective To discuss the clinic and radiology characteristic of multi-segmental lumbar disc herniation. To discuss the indication of Percutaneous lumbar discectomy associate with chemonucleolysis by collagenase. To evaluate the curative effects of multi-segmental lumbar disc herniation treated with PLD associate with chemonucleolysis by collagenase. And to discuss the prevent and disposal of complication of PLD associate with chemonucleolysis by collagenase. Methods Sixty-six patients with multiple levels lumbar disc herniation from 2002 March ~ 2004 January were analysed by the clinic symptom and radiology. And different methods were choosed with contained disc or noncontained disc diagnosed by radiological images. And the real-time and long-term curative effects were observed. Results Before the treatment, the numeric of symptom was 4.71 +2.77. After the treatment, the numeric of symptom was 12.76 + 2.38, the average improvement index number was 0.64 + 0.32, the improvement rate was 0.80 +0.21. And the total efficiency was 98.5%, the obvious rate was 81.8%, the efficiency was 16.7%, and the inefficiency was 1.5%. None complications occurred. Conclusion The multi-segmental lumbar disc herniation have below feature. The patients'age are older than 40. The processes of the disease are longer, and the paroxysms are regular. The symptoms are various and complex. It often accompanied with the symptoms of Sternosis and the decreasing of sensation. The changes of lumbar vertebrae regression are seen easily. The happens of L4/5 and L5/ SI discs are easily. The PLD is suitable for contained disc and the chemonucleolysis by collagenase is suitable for contained disc and noncontained. The bulged disc with clinical symptoms and bigger than 3.5 mm should be treared by PLD. Positive measures of prevention can be used to avoid the occurrence of the complications.