Abstract
Introduction
Puncture methods—Nucleoplasty by coblation and radio frequency denervation—have recently been widely used for the treatment of pain syndrome caused by intervertebral disc protrusion. The purpose of this study was to assess the effectiveness of nucleoplasty and radio frequency denervation of intervertebral joints as advanced minimally invasive surgical techniques for alleviating pain in the case of intervertebral disc disease, spondylarthrosis, and other vertebroneurologic diseases accompanying degenerative disc disease.
Methods
Since 2010, 70 patients with lumbar disc protrusion and signs disc-radicular conflict underwent nucleoplasty by cold plasma. All patients had a history of back pain or/and leg pain for not less than 3 months and were followed up after undergoing minimally invasive procedures for a year. Visual Analog Scale, Oswestry Disability Index (ODI), and Treatment Satisfaction Scale were used for evaluation. A total of 50 patients of control group also with protrusion of intervertebral disc were treated therapeutically.
Results
No complications were noted. At 12-month follow-up, all the operated patients showed the decrease of pain syndrome intensity according to the Visual Analogue Scale (p < 0.0001), and decrease ODI compared with patients treated therapeutically (p < 0.001). Treatment Satisfaction scores were higher as compared with the patients of the control group.
Conclusions
Nucleoplasty allowed us to successfully treat patients affected by lumbar disc protrusion who treated therapeutically not less than 6 weeks without effect. Minimally invasive electrosurgical techniques appeared to be safe and effective in the treatment of carefully selected patients suffering from low back and leg pains caused by a degenerative-dystrophic process. Nucleoplasty technique is more effective in younger patients. Procedures performed at several levels also result in marked clinical improvement. the primary advantages of these techniques were their safety and efficacy, minimal invasiveness, and the absence of a peridural scar. They do not complicate further microsurgical intervention.