Intradiscal Electrothermal Annuloplasty in Chronic Discogenic Low Back Pain

Oh, Wan Soo; Kang, Ho Jeong; Kim, Kwang Min

Abstract

Chronic discogenic low back pain remains a difficult treatment challenge. Also, Internal disc derangement in the lumbar spine is a common yet difficult clinical condition to treat. The reported prevalence of chronic low back pain due to intrinsic disc mediated pain is at least 40%. Internal disc derangement has characteristics such as degeneration of the collagen of the disc annulus, fissures, global disc degeneration, and herniation with or without root compression. The common treatment for chronic discogenic low back pain has been conservative, including physical therapy and pharmacological management but the effectiveness remians controversial. Surgical fusion offers modest results at best, but often fails, and is associated with complications and postoperative continued pain. The intradiscal electrothermal annuloplasty has become known as a safe and effective treatment for patients suffering from discogenic pain and offers the advantage of potentially repairing the damaged disc while maintaining normal disc function. We applied a navigable catheter with a temperature controlled thermal resistive coil, deployed intradiscally through a percutaneous extrapedicular approach under two plane fluoroscopic guidance in chronic low back patients. The authors experienced two cases of chronic discogenic pain that had failed to respond to any kind of conservative treatment but which was successfully relieved by the intradiscal electrothermal annuloplasty.