Efficacy of Single Level Versus Double Levels Surgery of Percutaneous Disc Nucleoplasty (PDN) Approach in Treating Lumbar Disc Herniation.

BACKGROUND Although percutaneous disc nucleoplasty (PDN) has been widely applied in treating lumbar disc herniation (LDH) in recent years, the efficacy of surgical levels for PDN on LDH has been reported in limited studies. This study aimed to explore and compare the efficacy of surgical levels (single level vs double level) of PDN in treating LDH. MATERIAL AND METHODS All patients diagnosed with LDH from January 2012 to December 2014 in our hospital who underwent PDN were included in this study. Patients were divided into a single-level group and double-level group based on the number of discs/surgical treatment levels. The improvement of visual analog scale (VAS) score, patient satisfaction, and reoperation occurrence were compared between the 2 groups. RESULTS Of 105 total patients, 75 patients were treated with single-level treatment and 30 patients with double-level treatment. VAS for leg pain and patient satisfaction scores in the double-level group were worse than those in the single-level group at 6 months after surgery (P<0.05). Among all 105 patients, the incidence of reoperation was 11.4%. Also, there was a marked difference in reoperation occurrence at 6 months after surgery between the single-level (6.7%) and double-level (23.3%) groups; however, the difference was not statistically significant (P=0.05). CONCLUSIONS PDN is a safe and minimal-invasive approach, which could effectively treat LDH. The number of surgical levels might be an important factor influencing the efficacy of PND. Caution should be exercised to strictly follow the clinical indications for nucleoplasty.