Plasma disc decompression compared to physiotherapy for symptomatic contained lumbar disc herniation: A prospective randomized controlled trial

Mehdi Nikoobakht; Mir Saeed Yekanineajd; Amir H Pakpour; Peter C Gerszten; Richard Kasch

doi:10.1016/j.pjnns.2015.11.001

Plasma disc decompression compared to physiotherapy for symptomatic contained lumbar disc herniation: A prospective randomized controlled trial

Neurol Neurochir Pol. 2016;50(1):24-30. doi: 10.1016/j.pjnns.2015.11.001. Epub 2015 Nov 28.

Authors

Mehdi Nikoobakht¹, Mir Saeed Yekanineajd², Amir H Pakpour³, Peter C Gerszten⁴, Richard Kasch⁵

Affiliations

¹ Department of Neurosurgery, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran.
² Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran.
³ Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Shahid Bahounar BLV, 3419759811, Qazvin, Islamic Republic of Iran; Department of Public Health, Qazvin University of Medical Sciences, Qazvin, Islamic Republic of Iran. Electronic address: [email protected].
⁴ Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
⁵ Clinic and Outpatient Clinic for Orthopedics and Orthopedic Surgery, University Medicine Greifswald, Greifswald, Germany.

PMID: 26851686
DOI: 10.1016/j.pjnns.2015.11.001

Abstract

Introduction: To evaluate clinical outcomes with PDD as compared with patients who underwent to standard physiotherapy intervention.

Material and methods: One-hundred-seventy-seven randomly assigned patients with primarily radicular pain associated with a single-level lumbar contained disc herniation were enrolled. Participants received either PDD (89 patients) or conservative physiotherapy care (88 patients).

Results: Patients in the PDD group had significantly greater reduction in leg pain scores and significantly improved VAS (p<0.001), Oswestry Disability Index (p<0.05), and 36-Item Short Form, than those in the physiotherapy group at 12 months. On subset analysis, patients achieved even better outcomes after PPD who: were younger, had a shorter period of radiculopathy, of male gender, and lower BMI. Patients with subacute pain reported better outcomes than those with chronic pain in the PDD group.

Conclusions: Patient selection for PDD over physiotherapy favored younger patients who presented with a shorter period of pain symptoms and who had a more favorable body habitus.

Keywords: Contained disc herniation; Disc decompression; Low-back pain; Minimally invasive spine surgery; Plasma disc decompression.

Publication types

Comparative Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Decompression, Surgical / methods*
Exercise Therapy / methods*
Female
Humans
Intervertebral Disc Displacement / rehabilitation*
Intervertebral Disc Displacement / surgery*
Low Back Pain / rehabilitation*
Low Back Pain / surgery*
Lumbar Vertebrae / pathology
Lumbar Vertebrae / surgery
Male
Middle Aged
Minimally Invasive Surgical Procedures
Orthopedic Procedures / methods*
Outcome Assessment, Health Care*
Prospective Studies