Management of chronic discogenic low back pain with a thermal intradiscal catheter. A preliminary report.
METHODS
A prospective nonrandomized clinical trial.


OBJECTIVE
To determine the outcome in a group of patients with chronic, function-limiting low back pain who met the criteria for interbody fusion surgery, but were instead treated with an intradiscal thermal catheter (SpineCath, Oratec Interventions, Inc., Menlo Park, CA).


BACKGROUND
This study represents the first reported trial of treatment for chronic discogenic low back pain with a novel thermal intradiscal catheter.


METHODS
The authors evaluated 25 consecutive patients. The minimum duration of nonoperative care with the authors was 6 months. The visual analog pain scores, sitting tolerance times, and SF-36 summary scores were tabulated.


RESULTS
The mean follow-up period was 7 months, and the mean duration of symptoms 58.5 months. Of the 25 patients, 20 (80%) reported a reduction of at least 2 points in visual analog pain scores, and 18 (72%) reported an improvement in sitting tolerance as well as reduction or discontinuance of analgesic medication. Visual analog pain scores improved by a mean reduction of 3.74, a 51% change (P = 0.0001). On the SF-36 physical function subscale, 72% of the patients improved by a mean increase of 15 points (P = 0.001), a mean change of 38%, and by a mean increase of 14 points on the bodily pain subscale (P = 0.004), a mean change of 48%.


CONCLUSIONS
A statistically significant improvement in functional outcome was obtained in patients with chronic discogenic low back pain treated thermally by the SpineCath.
Saal
J S
JS
SOAR, Physiatry Medical Group, Menlo Park, California, USA.
Saal
J A
JA
D000328:Adult; D002404:Catheterization; D002908:Chronic Disease; D005240:Feasibility Studies; D005260:Female; D006358:Hot Temperature / Q000627:therapeutic use*; D006801:Humans; D007403:Intervertebral Disc; D017116:Low Back Pain / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010865:Pilot Projects; D011446:Prospective Studies; D016896:Treatment Outcome