1. 2004;7;419-425Role of Percutaneous Disc Decompression using Coblation in Managing Chronic Discogenic Low Back Pain: A Prospective, Observational Study
   A Prospective Evaluation
   Vijay Singh, MD, Chandur Piryani, MD, and Katherine Liao, MD.

Background : Percutaneous disc decompression using Coblation (Nucleoplasty™) implements the principle of volumetric reduction to achieve disc decompression and reduce intradiscal pressure. Previous analyses have shown that Nucleoplasty achieves reduction in volume and intradiscal pressure with minimal damage to surrounding tissue in the treated disc.

Objective : To determine effectiveness of nucleoplasty in patients with discogenic back pain.

Study Design: A prospective, non-randomized, observational study.

Methods: Forty-seven patients presenting with predominant back pain undergoing treatment with the Nucleoplasty procedure using Coblation technology were included in this analysis. Patients were followed at 1 month, 3 months, 6 months, and 12 months after the procedure.

A numeric pain scale of 0 to 10, percent pain relief, and improvement in functional status as determined on the basis of their ability to sit, stand, and walk.

Results: The proportion of patients who reported 50% or more pain relief was 80%, 74%, 63% and 53% at the 1, 3, 6 and 12 months follow-up time periods, respectively. Functional improvements were reported by 46% of patients for sitting ability, 41% for standing ability, and 49% for walking ability at 12 months. There were no complications observed due to the Nucleoplasty procedure.

Conclusion:Nucleoplasty for disc decompression is one of the least-invasive techniques in the minimally invasive category, thus far exhibiting a very low incidence of complications. Although no long-term data are available, these preliminary results indicate that the Nucleoplasty procedure is a safe and moderately effective procedure for reducing pain in patients presenting with predominant discogenic low back pain associated with contained disc herniation.

Keywords: Low back pain, percutaneous disc decompression, nucleotomy, coblation, nucleoplasty, radiofrequency