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

Abstract

PurposeTo 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 methodsThis 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.ResultsTwo 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%.ConclusionThese 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.

Paravertebral Muscular Neurophysiological Function as an Independent Outcome Predictor of Recurring Herniation/Low Back Pain after Radiofrequency Ablation: A Prospective Follow‐Up and Case‐Control Study Based on Surface Electromyography

“…It has been reported in many clinical studies to range from 5% to 32.5%. [7][8][9] in Group N was mildly impaired: there was no typical electrical activity silence during the third phase, but the sEMG value of the third phase was lower than the re-extension (fourth) phase. (C) The FRP of the LM in Group R was severally impaired: there was no typical electrical activity silence during the third phase, and the sEMG value of the third phase was even higher than the re-extension (fourth) phase.…”

“…However, controversy remains about the clinical outcomes of ECRF. Postoperative recurring LDH/LBP is the main problem limiting its clinical application, which ranges from 5% to 32.5% 7–9 . The relationship between lumbar spinal muscular function and LDH has been receiving increasing attention in the published literature 10–13 .…”

“…Kim et al reported the rate of recurring LDH after ECRF as 5%-12% 9. A 10-year retrospective study of ECRF combined with collagenase chemonucleolysis for treating LDH found that only 65.08% of patients (82/126) experienced no pain, 3.17% of patients (4/126) experienced both LBP and sciatica, 2.38% of patients (3/126) experienced…”

Transforaminal epidural steroid injection combined with radio frequency for the treatment of lumbar disc herniation: a 2-year follow-up

“…Radio frequency can be used as a means that targets certain anatomical structures of interest, usually nerves. Some results show that the medium- and long-term treatment efficiency is satisfactory [ 6 , 7 ].…”

Transforaminal epidural steroid injection combined with radio frequency for the treatment of lumbar disc herniation: a 2-year follow-up

“…Radio frequency can be used as a means that targets certain anatomical structures of interest, usually nerves. Some results show that the medium-and long-term treatment e ciency is satisfactory [6,7].…”