Clinical Efficacy of Percutaneous Endoscopic Lumbar Annuloplasty and Nucleoplasty for Treatment of Patients with Discogenic Low Back Pain

Abstract

OBJECTIVES: This study assessed the effectiveness of percutaneous endoscopic lumbar annuloplasty and nucleoplasty (PELAN) for the treatment of patients with discogenic low back pain. STUDY DESIGN: Retrospective design SETTING: Spine hospital SUBJECTS: Forty-seven patients diagnosed as having discogenic low back pain, who were refractory to conservative treatments. METHODS: Outcomes were assessed using a numeric rating scale for back pain, the Oswestry disability index, and modified MacNab's criteria, at 2-3 weeks and at least 12 months after treatment. RESULTS: At long-term follow-up, 33 patients (70%) had successful outcomes for relief of pain, and the same proportion had successful reduction of disability. Although all patients took oral analgesics for pain control before PELAN, 25 (53%) required no analgesics at long-term follow-up. If success is defined as simultaneously achieving greater than 50% reduction in pain, greater than 40% reduction of disability, good or excellent MacNab criteria, and no need for analgesics, 23 patients (49%; with 95% confidence interval of 35-63%) achieved successful outcomes. CONCLUSIONS: In patients with discogenic low back pain refractory to conservative treatment, PELAN provided favorable clinical outcomes with success rates that rival those of surgery for this condition.