Combination use of multiple interventional techniques for the treatment of prolapse of lumbar intervertebral disc:therapeutic observation in 256 cases

Objective: To observe the therapeutic effect of combination use of multiple interventional techniques in treating lumbar intervertebral disc herniation. Methods: Combination use of ozone disc ablation, dissolution of disk with collagenase, windowing of fiber ring to reduce pressure within the disk and other endo-disc or extra-disc techniques was employed to treat 256 patients with lumbar intervertebral disc protrusion. The clinical results were analyzed and the technique was evaluated. Results: Combination use of multiple interventional techniques was completed for 437 diseased lumbar disks in 256 patients. The therapeutic efficacy was judged by Macnab criterion. Excellent effectiveness was obtained in 82.4% patients. And the response to treatment became better with time. The curative effect in patients with ruptured fiber ring was much better than that with no ruptured fiber ring. Conclusion: Combination use of multiple interventional techniques carries wide indications for the treatment of intervertebral disc protrusion and has excellent therapeutic efficacy. Collagenase has proteolytic effect on fiber ring, ozone possesses oxidation effect to the nucleus pulposus, and fiber ring windowing can reduce the pressure within the disk. All the above three techniques have their own distinguishing features. Based on imaging findings and the pressure within the disk, an optimal combination of theses techniques can surely bring satisfactory results. (authors)