目標：針對未破裂的椎間盤突出造成的下背部及下肢疼痛，椎間盤整形術及硬膜上沾粘清除術是可以考慮的微創治療方式。有一些研究討論過這些治療對日常生活功能及藥物使用量的影響，但合併這兩種治療方式的治療結果則尚未有人探討。我們研究的目標是要評估因一節未破裂的椎間盤突出造成的慢性下背痛及坐骨神經痛的病患，進行椎間盤整形術合併硬膜上沾粘清除術之預後。 方法：29位接受椎間盤整形術合併硬膜上沾粘清除術的病患加入本研究。病患在術後三個月，六個月及十二個月進行追蹤，並以0到10分的視覺類比計分表評估其疼痛程度。我們也記錄病患的藥物使用，並評估生活品質失能指數Oswestry Disability Index (ODI)。治療後三個月，六個月及十二個月的結果與術前做比較。 結果：術後的疼痛程度及藥物使用都有顯著減少。生活功能狀態在三個月，六個月及十二個月時都有進步。沒有任何與治療相關的併發症發生，而且我們發現接受合併治療者在各觀察的時間點有持續性的進步。 結論：椎間盤整形術合併硬膜上沾粘清除術不僅安全，且在術後早期或晚期都有顯著的效果。未來我們將進行隨機，控制的研究來評估合併治療的長期效果。
Objective: Both nucleoplasty and epidural neuroplasty have emerged as minimally invasive techniques for treatment of low back pain and sciatica due to contained herniated discs. Although there were some studies examining their effects on functional activity and pain medications, the results of a combination of the two procedures have not been analyzed as yet. The aim of our study was to evaluate the outcome of a combination therapy in patients with chronic discogenic pain or sciatica due to nerve root compression by a single-level, contained herniated disc. Methods: Twenty-nine patients who had undergone the combination therapy of both nucleoplasty and epidural neuroplasty were included in the analysis and were evaluated at 3, 6, and 12 months postoperatively. They were asked to quantify their pain using a visual analog scale ranging from 0 to 10. The Oswestry Disability Index (ODI) was used to quantify disability by third-party observers. Patients were also surveyed with regard to their use of pain medications. We compared the data at 3, 6, and 12 months posttreatment to the baseline. Results: There was a significant decrease in pain and use of medications in our study group. The functional status was improved at 3, 6, and 12 months. There were no complications associated with the procedure and we found continued improvements over time in the study group. Conclusion: Nucleoplasty and epidurolysis in combination appear to be safe and effective in both early and later post-treatment periods. Further randomized, controlled studies are required to evaluate the long-term efficacy of the combination therapy.