Nucleoplasty for treating lumbar disk degenerative low back pain: an outcome prediction analysis.
OBJECTIVE
Nucleoplasty is a minimally invasive technique that is considered efficacious in alleviating lumbar disk degenerative low back pain (LBP). The efficacy of nucleoplasty and identified variables that can predict pain relief for nucleoplasty was reported.


METHODS
Between December 2013 and November 2015, 47 nucleoplasty procedures on 47 lumbar disks in 31 consecutive patients were performed. The outcome was evaluated using a visual analog scale (VAS) score. Improvements of ≥50% in VAS scores were considered substantial pain relief. The variables associated with pain relief after nucleoplasty included: 1) age; 2) sex; 3) body mass index; 4) hyperintensity zone at the rear of the disk; 5) hypointensity of the disk; 6) Modic changes of the end plates; 7) spinal instability pain; and 8) discography results.


RESULTS
Twenty-one patients (67.7%) experienced substantial pain relief. The most common side effects following nucleoplasty were soreness at the needle puncture site (64.5%), numbness in the lower leg (12.9%), and increased intensity of back pain (9.7%). All side effects were transient. Multivariate analysis revealed that the discography results were the most critical predictor for substantial pain relief of nucleoplasty (P=0.03). The sensitivity and specificity of discography were 92.8% and 62.5%, respectively.


CONCLUSIONS
Discography results could improve the success rate of nucleoplasty in the treatment of disk degenerative LBP.
Department of Neurosurgery, E-Da Hospital.
Po-Chou
PC
Liliang
Department of Neurosurgery, E-Da Hospital.
Kang
K
Lu
Department of Neurosurgery, E-Da Hospital.
Cheng-Loong
CL
Liang
Department of Nursing, I-Shou University; School of Nursing, Kaohsiung Medical University.
Ya-Wen
YW
Chen
Department of Neurosurgery, E-Da Hospital.
Yu-Duan
YD
Tsai
Department of Orthopedic Surgery, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.
Yuan-Kun
YK
Tu
discography; low back pain; lumbar disk degenerative; nucleoplasty