Minimally invasive spinal surgery using nucleoplasty: a 1-year follow-up study.
BACKGROUND
Nucleoplasty is a minimally invasive percutaneous intradiscal coblation therapy option in patients with chronic discogenic low back pain. The purpose of this prospective study was to assess the effectiveness of nucleoplasty in our patients up to 1 year after treatment.


METHODS
All patients included in this study suffered from established back pain and/or radiating pain in the lower extremities. Age, gender, weight, body mass index (BMI) and smoking status were recorded and the clinical status of the patient documented using a visual analogue pain scale (VAS). Additionally, patients were asked to provide details regarding analgesic consumption, disability and ability to work. Nucleoplasty was carried out under fluoroscopic and CT-guidance. All treated patients were reviewed at 6 and 12 months.


RESULTS
Between April 2005 and December 2006, 96 patients underwent nucleoplasty in our department. The 69 patients reported here were followed-up to 12 months while data for eight others is available only up to 6 months. Seven patients were lost to follow-up, while eleven were excluded due to a secondary disc sequestration, either at the treated segment or elsewhere. The mean age of the 27 females (39%) and 42 males in this study was 42 years (range 18-74). The mean duration of symptoms was 30.5 months (range 1-120). Forty-two percent of patients were smokers and the mean BMI was 26.3 (17.4-42.4). 73% of treated patients experienced an improvement of more than 50% in their symptoms in the early post-operative VAS score. This was reduced to 61% at 6 months post-operatively and 58% after 1 year. A statistically significant reduction in analgesic consumption, disability and occupational incapacitation resulted from treatment with nucleoplasty.


CONCLUSIONS
Nucleoplasty is an effective therapy for chronic, discogenic back pain which results in significant reductions in levels of disability and incapacity for work as well as decreased analgesic consumption.
Al-Zain
Ferass
F
Department of Neurosurgery, Unfallkrankenhaus Berlin, Warener Strasse 7, 12683 Berlin, Germany. al-zain@t-online.de
Lemcke
Johannes
J
Killeen
Tim
T
Meier
Ullrich
U
Eisenschenk
Andreas
A
D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D000700:Analgesics / Q000627:therapeutic use; D004185:Disability Evaluation; D017587:Diskectomy, Percutaneous / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007403:Intervertebral Disc / Q000033:anatomy & histology / Q000473:pathology / Q000601:surgery*; D007405:Intervertebral Disc Displacement / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D017116:Low Back Pain / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation / Q000379:methods; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D018582:Sick Leave / Q000706:statistics & numerical data; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
D000700:Analgesics