Percutaneous lumbar discectomy: one-year follow-up in an initial cohort of fifty consecutive patients with chronic radicular pain.

Discogenic leg pain is a primary cause of health care expenditure in the U.S.A., afflicting nearly 10 million people at an estimated cost of over $20 billion.(1,2) This pain is often due to herniation of the intervertebral disc (3-5) and clinically characterized as compressive or noncompressive. (3) Compressive herniations have been treated with open surgical discectomy/decompression when a progressive motor, sensory, and/or reflex change (ie, radiculopathic pattern) is noted on serial neurologic exam. (6,7) In that setting, surgical disc decompression has produced clinical improvement by reducing pressure within the intervertebral disc and adjacent nerve root. (8) The efficacy of that approach may be limited, however, by reherniation and/or reoperation depending on the amount of annular invasion required. (7) As a result, open surgical disc decompression may be ineffective in some patients (6,7) and is associated with morbidity. (7,9-11)