Clinical Outcomes
Clinical Outcomes
Multiple clinical studies have shown that percutaneous discectomy using the Stryker Dekompressor® is successful for 90% of patients.[1] Reported beneficial results include:
- Significant pain relief[2][3]
- Reduced use of analgesics[2][3]
- Returns patients to their previous levels of activity[2]
- Quantifiable disc material removal[2]
- Less epidural scarring
- Quick recovery: generally 3 to 5 days
- Low complication and morbidity rates[4][5][6][7][8][9][10][11][12]
- Outpatient procedure requiring only local anesthetic alleviates possible complications of open surgery and general anesthesia
A multi-center study by KM Alò, J Sutcliffe, and SA Brandt obtained effective disc removal and pain relief with the Stryker Dekompressor probe at 1 year:[13][14]
| Outcome | 6 Mo | 1 Year |
|---|---|---|
| Pain Reduction | 60% | 65% |
| Analgesic Reduction | 74% | 79% |
| Functional Improvement | 90% | 91% |
| Overall Satisfaction | 80% | 88% |
Percutaneous discectomy (PLD) is associated with reductions in complications and recovery times compared to open disc surgery. G Onik and co-workers published case reports in 1987 on percutaneous aspiration of a herniated lumbar disc using an automated instrument.[15] Successful results were seen in 31 of the 36 patients (86%) with no significant complications observed secondary to the percutaneous discectomy.
In 1989, GW Davis and G Onik[16] evaluated 200 consecutive patients treated with PLD, reporting an overall success rate of 77.5% at 6 months follow-up,with no occurrences of intraoperative or postoperative complications.
A prospective, multi-institutional study was published by G Onik and co-investigators in 1990[17] where results were presented for 327 patients undergoing PLD performed by 18 surgeons in 17 centers. Of the 327 patients who prospectively met the study criteria and were followed for more than 1 year, 75.2% were successfully treated. Only one case of discitis was reported with no other serious complications noted. In particular, no vascular or nerve damage was encountered.
A significant number of other clinical investigators have now published their experiences with mechanical PLD. In a 1989 article in Clinical Orthopaedics and Related Research, JC Maroon, et al, reported on 481 patients treated with automated percutaneous discectomy probes.[18] Only 2 patients (0.4%) suffered discitis infections (successfully treated with antibiotics), one case of soft-tissue hematoma was noted, and there was no instance of great vessel or nerve damage associated with the procedure.
K Gill and SL Blumenthal published in 1991[19] about their use of PLD in 62 patients. No neurologic injuries or major blood vessel injuries were observed. A follow-up report by these same authors in 1993[20] where the series was expanded to include 109 patients found no occurrences of neurologic or major blood vessel injuries.
In 1992, WH Castro, et al, [21]reported on a 97-patient study of PLD where zero complications were reported for the total group.
In a limited study of 21 patients published by SJ BK Tay[22] in 1993 on PLD in the Singapore Medical Journal, no patients treated had any complications or were made worse by the procedure.
In 1997, R Mathews, et al,[23] published the results of a prospective study of PLD in 45 patients following a defined protocol of physical and diagnostic evaluation. Of these patients, 82.2% had an excellent, very good, or good result. No patient was found to have suffered infection, bleeding, or neurovascular compromise during the more than 6-month post-operative period.
