Percutaneous annuloplasty in the treatment of discogenic pain: retrospective evaluation of one year follow-up.
In this study, we have evaluated clinical results of the discTRODE system, in 15 patients with discogenic pain. All procedures were performed under sterile conditions with fluoroscopic guidance. After identifying the disc space under fluoroscopy, the introducer of the discTRODE was introduced using a tunneled vision. After inserting the introducer; navigable, semi-rigid discTRODE catheter was advanced through the introducer and directed medially and contralaterally along the posterior nuclear-annular interface. The SMK Thermocouple Electrode was placed in the outer-annulus on the contralateral side so as to monitor local tissue temperature. The treatment temperature was manually increased in a step-wise progression from 50 degrees C to 65 degrees C. Patient outcomes were evaluated during follow-up visits at 1, 3, 6 and 12th months post-procedure. Before the procedure and at each visit during the follow-up period, patients completed Visual Analogue Pain Scale (VAS) and Short Form-36 Health Status Questionnaire (SF-36). Annuloplasty was performed without difficulty in all patients, there were no complications associated with disc puncture such as discitis or disc rupture. Symptoms improved in 10 of 15 (66.6 %) of the patients on the SF-36 Physical Function subscale, in 9 of 15 (60 %) on the SF-36 Bodily Pain subscale and in 9 of 15 (60 %) on the VAS scores. 5 of 15 of the patients did not show improvement on any scale. This technique seems to be a reliable method for patients complaining of discogenic pain. However, prospective randomized controlled studies comparing different approaches are needed.
Erdine
Serdar
S
Istanbul University, Istanbul Faculty of Medicine, Department of Algology, Istanbul, Turkey. algomed@superonline.com
Yucel
Aysen
A
Celik
Mehmet
M
D000328:Adult; D004598:Electrosurgery / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006358:Hot Temperature; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000473:pathology / Q000601:surgery*; D017116:Low Back Pain / Q000473:pathology / Q000601:surgery*; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D010147:Pain Measurement; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome