title: Discogenic axial back pain: is there a role for nucleoplasty?
abstract: METHODS
  A prospective observational study.
  
  
  OBJECTIVE
  To evaluate the role of nucleoplasty in the management of discogenic axial back pain; to determine the influence of concordant pain during provocative discography, annular tear and loss of disc height on the outcome of nucleoplasty.
  
  
  BACKGROUND
  The role of nucleoplasty in the management of radicular leg pain due to disc herniation is known. However, the data regarding its role in the management of discogenic axial back pain is scarce.
  
  
  METHODS
  A prospective evaluation of 30 patients with discogenic axial back pain undergoing nucleoplasty was performed. Pain, functional disability and quality of life were assessed using the 100 mm visual analogue scale (VAS), Oswestry Disability Index (ODI) and Short Form-36 (SF-36), respectively.
  
  
  RESULTS
  The mean reduction in VAS was 31.03 and 29.03; mean reduction in ODI was 24.53 and 20.60; and mean increment in SF-36 was 13.58 and 12.30, at 6 months and at 12 months, respectively. The differences were statistically significant (p <0.05). Concordant pain during provocative discography, annular tear and loss of disc height did not affect a clinically significant improvement in any of the three outcomes (p =0.882, 0.213, and 0.170; respectively).
  
  
  CONCLUSIONS
  Nucleoplasty produced statistically significant improvements in pain, functional disability and quality of life in patients with discogenic low back pain at 6 months and at 12 months. Concordant pain during provocative discography, annular tear and loss of disc height did not influence any of the outcomes after nucleoplasty in patients with discogenic axial back pain.
authors.affiliation: Department of Orthopaedic Surgery, University Spine Centre, National University Hospital, Singapore.
authors.forename: Naresh Satyanarayan
authors.initials: NS
authors.lastname: Kumar
authors.affiliation: Department of Orthopaedic Surgery, National University Hospital, Singapore.
authors.forename: Siddharth M
authors.initials: SM
authors.lastname: Shah
authors.affiliation: Department of Orthopaedic Surgery, University Spine Centre, National University Hospital, Singapore.
authors.forename: Barry Wei Loong
authors.initials: BW
authors.lastname: Tan
authors.affiliation: Department of Orthopaedic Surgery, National University Hospital, Singapore.
authors.forename: Salam
authors.initials: S
authors.lastname: Juned
authors.affiliation: Department of Orthopaedic Surgery, University Spine Centre, National University Hospital, Singapore.
authors.forename: Kaihan
authors.initials: K
authors.lastname: Yao
keywords: Axial back pain; Degenerate disc disease; Nucleoplasty; Radiofrequency treatment