Abstract
Introduction
Back pain due to Lumbar Disc Disease is a major clinical problem. The treatment options range from physiotherapy to fusion surgery. Several minimally invasive procedures have also been developed in the recent past for its management. Disc-FX® is a new minimally invasive technique that combines percutaneous discectomy, nuclear ablation and annular modification.
Methods
We studied 22 consecutive patients who underwent Disc-FX for lumbar disc pathology non-responsive to non-operative treatment for at least 6 months. Based on MRI, these patients fell into 2 groups – 11 with degenerative disc disease (DDD) and 11 with a contained lumbar disc herniation (CLDH). They were evaluated using Visual analogue scale (VAS), Oswestry Disability Index (ODI) and Short Form-36 (SF-36) scores preand postoperatively.
Results
Overall rate of re-intervention for persistent symptoms was 18.18% (4/22) - all in CLDH subgroup (4/11, 36.36%). At 6 months, mean pre-op VAS improved from 6.1 (2–8) to 3.42 (0–7), ODI reduced to 28.21 (2–68.9) from 37.64 (2–71.1) and SF-36 improved from 35.57 (24.1–56.8) pre-op to 40.463 (24.1–56.8). 9 (42.85%) patients (4 with CLDH, 4 with DDD and 1 with both) said that they were not satisfied with the treatment and would not recommend it. 8 (38.09%) patients (5 with DDD, 2 with CLDH and 1 with both) who had partial to complete pain relief were satisfied and would recommend the procedure. 4 (19.04%) patients (1 with DDD and 3 with both) were not sure. 3 were advised fusion or disc replacement. The only complication of this procedure was inability to access the L5-S1 disc space in 3 patients.
Conclusions
Our study suggests thatDisc-FX®is a reasonable treatment option for patients with back pain due to lumbar disc disease, especially with DDD who fail conservative treatment. It could be an alternative to procedures like fusion or disc replacement. Longer term prospective studies are needed to prove its role in treatment of patients with CLDH.