Rezumat Comparaåie între nucleoplastia percutanã aei discectomia deschisã la pacienåii cu protruzii discale lombare Introducere: Nucleoplastia prin coblaåie este o metodã minim invazivã situatã la mijlocul distanåei dintre tratamentul conservator şi cel operator classic al degenerãrii discului lombar asociat cu protruzie discalã. Autorii comparã rezultatele obåinute prin tratamentul minim invaziv şi cel operator classic al acestei afecåiuni. Material şi rezultate: Pacienåii din douã grupe (fiecare grupã având 80 de pacienåi) au fost trataåi prin cele douã metode. Pacienåii cu simptomatologie radicularã produsã de protruzii discale cu diametrul antero-posterior < 6 mm, rezistente la tratamentul conservator, au fost operaåi prin nucleoplastie. În situaåia în care diametrul antero-posterior al discului herniat a fost > 6 mm, s-a aplicat metoda discectomiei clasice. În grupul tratat prin discectomie deschisã ameliorarea durerii radiculare a fost imediatã, dar la 1 an postoperator doar o treime dintre pacienåi şi-au reluat munca. În grupul tratat prin nucleoplastie ameliorarea durerii a fost mai lentã dar progresivã. La un an postoperator scorul VAS al pacienåilor trataåi prin cele 2 metode este foarte apropiat. Toåi pacienåii şi-au reluat munca la 3 zile dupã nucleoplastie. În acest grup nu au existat complicaåii intraoperatorii sau postoperatorii. Un pacient a fost ulterior operat prin discectomie clasicã. Concluzie: Nucleoplastia prin coblaåie este o metodã de tratament eficientã şi sigurã a protruziilor discale lombare. Cuvinte cheie: nucleoplastie, coblaåie, discectomie Abstract Introduction: Coblation nucleoplasty is a minimally invasive method, at middle way between conservative and open surgical treatment of patients with degenerative disc disease and lumbar disc protrusion. Authors compare the outcome of patients treated through the two methods. Material and results: Two groups of 80 patients each were treated through open discectomy and nucleoplasty. Patients with radicular symptoms caused by disc protrusions, having antero-posterior diameter of herniated disc < 6 mm, resistant to conservative treatment, were operated using nucleoplasty. When antero-posterior diameter of the disc herniation was > 6 mm, classical discectomy method was applied. Classical surgeries (discectomies) were performed by the senior author (D.A.), while the nucleoplasty procedures all three authors equally participated. In the first group improvement of radicular pain was immediate. At 1 year after the procedure only one third of the patients returned to work. In the group treated through nucleoplasty improvement of pain was slow but gradual. After 1 postoperative year the VAS score of patients treated through the two methods were very close. At 3 days post nucleoplasty all patients returned to work. In this group there were not intraoperative or post-operative complications. One patient was afterwards operated through open discectomy. Conclusion: Coblation nucleoplasty is a safe and efficient method to treat patients with lumbar disc protrusion
