Twelve-month follow-up of a controlled trial of intradiscal thermal anuloplasty for back pain due to internal disc disruption.
METHODS
Case-control study.


OBJECTIVE
To determine the prima facie efficacy of intradiscal electrothermal anuloplasty (IDTA).


BACKGROUND
Although it is being used increasingly as a putative treatment for internal disc disruption, no studies have been published on the efficacy of IDTA.


METHODS
Fifty-three patients with back pain determined by computed tomographic (CT)-discography to be due to internal disc disruption were offered treatment. The outcomes of 35 patients treated with IDTA were compared with those of a convenience sample of 17 patients treated with a physical rehabilitation program, by using a visual analog pain scale, use of analgesics, and return to work as measures.


RESULTS
At 3 months, only one control patient obtained any significant degree of relief of pain, compared with 23 in the index group. Relief of pain was sustained at 6 and 12 months and was associated with improvement in disability, reduced drug use, and a return to work rate of 53%. Depending on the stringency of criteria used, the success rate of IDTA may be as low as 23% or as high as 60% with confidence intervals of +/-16%.


CONCLUSIONS
In carefully selected cases, IDTA can eliminate or dramatically reduce the pain of internal disc disruption in a substantial proportion of patients and appears to be superior to conventional conservative care for internal disc disruption.
Karasek
M
M
Northwest Spine Group, Eugene, Oregon 97401, USA.
Bogduk
N
N
D000328:Adult; D004185:Disability Evaluation; D004599:Electric Stimulation Therapy / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data*; D004564:Electrocoagulation / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007403:Intervertebral Disc / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D007405:Intervertebral Disc Displacement / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D017116:Low Back Pain / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000706:statistics & numerical data; D011859:Radiography; D016896:Treatment Outcome