Anuloplastia en el dolor lumbar de origen discógeno, experiencia a corto plazo en el C.M.N '20 de Noviembre': Reporte de 10 casos

摘要

Objetives. We evalúate the efficacy of the intradiscal annuloplasty with radiofrecuency in the treatment and management of chronic lumbar discogen pain. Materials and Methods. We evalúate 10 patients from the Pain Clinic of the C.M.N "20 de Noviembre" of the ISSSTE, with chronic lumbar discogen pain due to intervertebral disc hernation in one or two vertebral discs, we found 10 patients between 30 to 55 years, 6 females, 4 male. All patients previously have positive fluoroscopic guided discography performed under local anesthesia previous the lumbar intradiscal annulplasty ,the fluoroscopic guidance allow us the correct localization of the Kambin Triangule as the entry reference to the posterior área of the intervertebral disc. All procedures where performed using the special radiofrecency catheterelectrode supplied by Radionics" (FK-DISCTRODE). Thermal lesión where made with the RFG-3cPlus radiofrecuency equipment by Radionics? for 10 minutes at 70oC (158oF). All patients where evaluated by Visual analogue scale and the Discapacity Oswestry index previous the procedure and after (1,3 and 6 moths). The statistical analisys was performed using the SPSS software for Windows versión 14 th (www.spss.com). Results. We found that the mean VAS was 8.9±1.1, initial mean reported Oswestry index of 50.1±10. After performing the intradiscal annuloplasty the patients reported a mean Oswestry índex of 36.5 of and VAS of 6 at 1st month, a mean Oswestry índex of 24 and VAS of 4 at three months and a mean Oswestry índex of 20.5 and VAS of 2-8 after 6 months-Statistical analisys performed with ANOVA showed the VAS reduction was more significant at 3 months but no statistically significant (p=0.021) in the Oswestry índex we found that the reduction was no statistically significant this probably due to our small number of patients in our study. Conclusions. The radiofrecuency intradiscal annuloplasty is an alternative to patients with chronic lumbar discogen pain in their control and management, often is an option to avoid surgical management. As a minor procedure thisallow the patients prompt recovery and return to their social and family.