Comparative Prospective Randomized Study Comparing Conservative Treatment and Percutaneous Disk Decompression for Treatment of Intervertebral Disk Herniation

Purpose: To compare short-, intermediate-, and long-term functional results concerning pain reduction and mobility improvement between conservative therapy and percutaneous disk decompression (PDD) in patients with intervertebral disk herniations. Materials and Methods: The study received approval from both the university ethics panel and the institutional review board. Patients provided informed consent for the study. Over the past 4 years, two randomized groups of 31 patients with sciatica due to intervertebral disk herniation were prospectively studied and compared with the t test. The control group underwent conservative therapy (administration of analgesics, antiinflammatory drugs, muscle relaxants, and physiotherapy) for 6 weeks. The decompression group underwent fluoroscopically guided PDD. Pain reduction and mobility improvement were recorded at 3-, 12-, and 24-month follow-up on a numeric visual scale (NVS) (range, 0-10). Results: The control group had a mean pain score of 6.9 NVS units +/- 1.9 prior to conservative therapy. This was reduced to 0.9 NVS units +/- 2.0 3 months after therapy; however, it increased to 4.0 NVS units +/- 3.4 at 12-month follow-up and further increased to 4.0 NVS units +/- 3.4 at 24-month follow-up. The decompression group had a mean pain score of 7.4 NVS units +/- 1.4 prior to PDD. This was reduced to 3.0 NVS units +/- 2.4 at 3-month follow-up and further reduced to 1.7 NVS units +/- 2.4 at 12-month follow-up and 1.6 NVS units +/- 2.5 at 24-month follow-up. No complications were noted. Conclusion: When compared with conservative therapy, PDD shows improved amelioration of symptoms at 12-and 24-month follow-up. (C) RSNA, 2011