Two-year clinical outcomes of radiofrequency focal ablation using a navigable plasma disc decompression device in patients with lumbar disc herniation: Efficacy and complications

Nack Hwan Kim, Youngki Hong, Sang Heon Lee

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    Abstract

    Purpose: To report on the 2-year clinical outcomes of focal ablation using a navigable plasma disc decompression device in patients with lumbar herniated nucleus pulposus (HNP). Patients and methods: This was a prospective, single-cohort study conducted in a clinical center. A total of 170 patients with lumbar HNP were assessed for pain intensity using the visual analog scale (VAS), for disability level using the Oswestry Disability Questionnaire (ODI), for health-related quality of life using the short form-36 version 2 of the bodily pain scale (SF-36 BP), and for the angles of passive straight leg raise (SLR) test. The herniated portions of the target discs were ablated using a navigable catheter under a well-instructed protocol with informed consent. Outcome data were prospectively collected before the procedure: 1 week after the procedure: and then 1, 3, 6, 12, and 24 months postoperatively. For statistical analysis, repeated-measures analysis of variance was performed. Results: Two years after the procedure, the mean VAS decreased from 7.1±1.7 to 2.1±1.9, the mean ODI decreased from 50.9±17.2 to 20.3% ± 14.6%, and the mean SF-36 BP increased from 38.8±8.4 to 45.8±9.4 (P<0.05). On the SLR test, the angular change after 2 years improved considerably from 51.2±17.3 to 85.0±9.3 degrees. There was 90%–100% VAS improvement in 25.9% and 50%–90% VAS improvement in 52.4% of the patients; 1.8% experienced pain aggravation compared with the initial VAS. Two subjects showed short-term foot drop, whereas one subject showed the severe complication of foot drop for more than 6 months. The recurrence rate ranged from 4.7% to 11.5%. Conclusion: These findings suggest that focal ablation of herniated discs using a navigable disc decompression device is worth considering for relieving pain related to lumbar HNP. However, the development of more advanced technologies and methods for safety and efficiency is necessary.

    Original languageEnglish
    Pages (from-to)2229-2237
    Number of pages9
    JournalJournal of Pain Research
    Volume11
    DOIs
    Publication statusPublished - 2018

    Keywords

    • Herniated disc
    • Low back pain
    • Minimally invasive surgical procedures
    • Percutaneous catheter ablation

    ASJC Scopus subject areas

    • Anesthesiology and Pain Medicine

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