Introduction: The preferred treatments for discogenic axial or radiating lower back pain are controversial. Available treatments are medication, physical therapy, epidural steroid, percutaneous endoscopic discectomy, open surgical discectomy, etc. A radiofrequency-assisted minimally invasive lumbar manual discectomy with nucleus ablation and annulus modulation by Elliquence’s “Disc-Fx system” has been successfully used to treat nine patients for their low back pain.
Materials and methods: Nine patients (35–55 years/M:F = 2:7) with lower back pain radiating to leg that failed to improve with conservative managements for more than 6 weeks were assigned. The magnetic resonance imaging shows moderate size of single contained disc herniation at L4-5 or L5-S1 with minimal degenerative changes (preserved disc height). All Disc-Fx procedures were performed in a day care basis under fluoroscopic guidance under local anesthesia with or without minimal sedation. Evaluation with a global assessment scale at 6 weeks, 3- and 6-months interval was done.
Results: All the patients underwent Disc-Fx treatment at one level, either L4-5 or L5-S1, after confirming the diagnosis with preoperative provocative discography. Mean operation time was 60 to 90 minutes, mean postoperative recovery time was 60 to 90 minutes, and blood loss was minimal. Mean return to normal day-to-day activities was 7 days. The numerical rating scale score was significantly lower than before operation. No complication occurred except in one patient, who was not satisfied symptomatically (contacted on phone), but did not come for follow-up after procedure till date.
Conclusion: Disc-Fx is an effective treatment option in discogenic pain and degenerative moderate contained disc prolapsed without bony and soft tissue stenosis. This minimally invasive approach does have advantages of no bony instability and minimal scarring/adhesion of epidural space, and thus, reduces postoperative complications to a great extent. It reduces hospital stay and leads to faster rehabilitation and early return to work, which reduces the cost of the treatment.
Keywords: Annulus modulation, Disc herniation, Disc-Fx, Discogenic pain, Low back pain, Manual discectomy, Nucleus ablation.
How to cite this article: Mallick S. Radiofrequency-assisted minimally Invasive Manual Lumbar Discectomy using Disc-Fx System: Outcome of Nine Cases. J Recent Adv Pain 2017;3(1):7-13.
Source of support: Nil
Conflict of interest: None