1. 2003;6;273-280Evaluation of Percutaneous Disc Decompression Using Coblation in Chronic Back Pain With or Without Leg Pain
   An Original Contribution
   Vijay Singh, MD, Chandur Piryani, MD, and Katherine Liao, MD.

The intervertebral disc is the focal point of pathology for most low back pain. Contained disc herniation is a common cause of low back pain and, when unresponsive to conservative measures, is often treatable by disc decompression.

To evaluate the safety and efficacy of percutaneous disc decompression using Coblation (Nucleoplasty) in the treatment of back and/or leg pain associated with contained disc herniation, a prospective, nonrandomized cohort analysis was conducted in an interventional pain management practice. Patients were followed for twelve months post procedure.

Eighty patients who presented with discogenic low back pain with or without radicular pain associated with contained disc herniation underwent percutaneous disc decompression using Coblation™ technology (Nucleoplasty™) after failing at least 3 months of conservative and injection therapies.

Overall, 75% of patients indicated a decrease in their numeric pain scores at 12 months with a statistically significant reduction in numeric pain scores of 2.43 ± 2.47 (p‹0.0001) compared to baseline. A total of 54% of patients indicated pain relief of 50% or more at twelve months. Additionally, significant improvement was reported by 54%, 44%, and 49% of patients in sitting, standing and walking abilities, respectively, at 12 months. There were no instances of complications.

These results indicate that disc decompression using Coblation (Nucleoplasty) is a safe and efficacious procedure for reducing discogenic low back pain with or without leg pain.

Keywords: Percutaneous disc decompression, nucleotomy, contained disc herniation, discogram, coblation, nucleoplasty, radiofrequency, discitis