The Onik method of automated percutaneous diskectomy in the treatment of the herniated lumbar disk offers undeniable advantages which we have already elaborated in our preliminary studies. Nevertheless, further experience with this technique has allowed us to pinpoint several aspects worthy of more attention: patient selection and long-term results. The patient selection procedure must follow Maroon and Onik's original protocol to the letter in order to single out those patients in whom contained disk herniation has caused actual sciatic pain and not merely low back pain. Imaging tests such as CT scan, MRI, and myelography have proved useful mainly in identifying contraindications for the technique, while only intraoperative diskography has been capable of diagnosing the contained status of the disk herniation, the basic criterion for selection. We reviewed 98 automated percutaneous lumbar diskectomies after a follow-up period ranging from 6 months to 2 1/2 years and found the results to be satisfactory, in spite of a slight deterioration of the good results at 6-9 months, following which there was no further change.
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