Evaluating 11 Years of Computed Tomography–guided Percutaneous Lumbar Herniectomy: A Clinical and Functional Outcome Analysis

Purpose or Learning Objective: Lumbar disk herniation is a major cause of radicular pain and a leading indication for spinal surgery. Advances in minimally invasive techniques have emerged as key alternatives to avoid more invasive surgical procedures. This study evaluates the clinical, functional, and safety outcomes of computed tomography–guided percutaneous lumbar herniectomy over an 11-year period.

Methods or Background: This prospective single-institution study included patients treated between February 2012 and July 2023. Inclusion criteria comprised radicular pain due to contained lumbar disk herniation unresponsive to conservative treatment and computed tomography–guided periradicular infiltration. Clinical outcomes were assessed using the Visual Analog Scale for pain, Quebec Back Pain Disability Score, Straight Leg Raise test, Finger-to-Ground Distance, and Schober test. Follow-up consultations were conducted at 1 month, 3 months, and 6 months with the primary outcome analysis set at 1 month after the procedure. Statistical analyses included the Wilcoxon signed rank tests and Cox proportional hazards regression.

Results or Findings: A total of 173 patients were analyzed. The median Visual Analog Scale score significantly decreased from 8 (interquartile range [IQR]: 6–8) preoperatively to 2 (IQR: 1–4) at 1 month (P < 0.001), with sustained improvement at 6 and 12 months. Functional and clinical outcomes significantly improved across all measures. No severe complications were reported, although five cases of postprocedural headache required blood patch treatment.

Conclusion: Computed tomography–guided percutaneous herniectomy is a safe and effective alternative for lumbar disk herniation, providing rapid and sustained pain relief with minimal complications. This study supports its consideration as a first-line treatment before a more invasive surgical intervention.

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Artikel online veröffentlicht:
02. Juni 2025