Nucleoplasty is effective in reducing both mechanical and radicular low back pain: a prospective study in 87 patients.

STUDY DESIGN

A prospective study of all patients with either mechanical back pain or radicular back pain who underwent nucleoplasty and were followed up prospectively.

OBJECTIVE

To investigate the effectiveness of nucleoplasty procedure in terms of pain and quality of life using the visual analog scale and Oswestry disability questionnaires.

SUMMARY OF BACKGROUND DATA

Nucleoplasty is a method of increasing popularity in the past few years. It has a role when dealing with pain of spinal origin either radicular or both radicular and mechanical after conservative treatment has failed and before open procedure.

METHODS

Eighty-seven patients with a minimal follow-up of 1 year were prospectively followed after they underwent nucleoplasty procedure for either radicular or a combination of radicular and mechanical low back pain. All patients underwent physical examination and completion of visual analog scale score and Oswestry Disability questionnaires after 1, 3, 6, and 12 months. Thirty-nine of them were followed after 2 years.

RESULTS

After 1 month, 66 patients (76%) were satisfied with the results. After 3 months, 60 patients (69%) had significant pain relief, whereas in 27 cases (31%) there was no improvement. After 6 months of follow-up, 57 patients (66%) had pain relief and in 30 cases (34%) there was no effect. At 12 months of follow-up, 55 patients (65%) showed good results and 30 patients (35%) had no effect. In the case of the 39 patients who were followed for 24 months, 23 patients (59%) had significant pain relief. A statistically significant reduction in the Oswestry index was also noted for the series in all intervals. Minor complication occurred in 23 patients (26%) who had transient discomfort and burning pain at the insertion site of the nucleoplasty wire.

CONCLUSIONS

We concluded that the nucleoplasty technique is a safe and effective procedure for radicular or combined radicular and mechanical low back pain and should be used in selected cases before open surgery after conservative treatment has failed.