Six months post-operative clinical and 24 hour post-operative MRI examinations after nucleoplasty with radiofrequency energy

Summary Background. Minimally invasive techniques are gaining popularity for the treatment of discogenic low-back pain. Nucleoplasty is a relatively new procedure that uses radiofrequency energy to disintegrate and evacuate the disc material. The purpose of this study is to examine the early post-operative radiological changes after lumbar nucleoplasty and to assess the short-term effects of this procedure on discogenic lower back pain and leg pain. Methods. Twenty nine patients between the ages of 32 and 59 years (mean 44.14, SD 7.11 years) were included in the study. Visual Analogue Scale (VAS) scores of the patients were recorded in the pre-operative period and 24 hours, 3 months and 6 months after the procedure. Additionally, pre-operative and post-operative lumbar magnetic resonance imaging (MRI) examinations of these patients were compared. Findings. The mean pre-operative VAS score was 6.95 (range 3.0–10.0, SD 1.87) and the mean post-operative VAS scores at 24 hours, 3 months and 6 months were 2.46 (range 0–8.0, SD 2.07), 4.0 (range 0–10.0, SD 3.09) and 4.53 (range 0–10.0, SD 3.6), respectively. There were statistically significant reductions (p < 0.001) in VAS scores for all post-operative time points when compared to pre-operative values. Nucleoplasty did not produce obvious changes at least on the early post-operative MRI examination. Conclusions. Although, nucleoplasty appeared to be a safe minimally invasive procedure, the value of this new technique for the treatment of discogenic low-back pain remains as yet unproven. Further randomised placebo-controlled studies with longer follow-up are needed to elucidate the effects of nucleoplasty on discogenic low back and leg pain.