Annulo-nucleoplasty using Disc-FX in the management of lumbar disc pathology: Early results

Naresh Kumar; Aravind Kumar; Shah Siddharth M; Shah Sambhav P; Justin Tan

doi:10.14444/1018

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Fig. 1
1A shows the position of the Disc-FX cannula relative to the focal disc relapse. 1B shows the possibility of a recurrent disc prolapse through the annulotomy rent.

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Table 1

Inclusion and Exclusion criteria

Inclusion Criteria

Age between 18 and 60 years
Axial back pain with degenerative disc disease (DDD) or back pain with leg symptoms for patients with contained lumbar disc herniation (CLDH)
Symptoms unresponsive to at least six months of conservative management
Pre operative Visual analogue scale (VAS) score ≥5
Magnetic Resonance Imaging (MRI) revealing degenerate/symptomatic discs at not more than one level
Disc level to be intervened falls within Pfirrmann's grade 2-4

Exclusion Criteria

Back pain due to lumbosacral strain or facet arthritis
Workmen compensation patients
A clear history or MRI pointing towards acute disc prolapse/sequestrated disc
Previous lumbar spine surgery
Spondylolisthesis
Infection/Malignant spinal conditions
Instability/Cauda equina syndrome

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Table 2
Visual analogue scale (VAS), Oswestry Disability Index (ODI) and Short form-36 (SF-36) scores at different time intervals for the entire study population.
Preoperative Post-operative 6 months 1 year
VAS 6.5 3.08(0.00) 3.77(0.00) 3.99(0.015)
ODI 43.16 23.25(.00) 28.32(0.005) 27.14(0.024)
SF-36 37.91 - 41.46(0.066) 42.89(0.086)
Figure in parentheses indicates p value when compared to the respective preoperative score. SF-36 scores were recorded only at 6 months and 1 year postoperatively.

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Table 3

Visual analogue scale (VAS), Oswestry Disability Index (ODI) and Short form-36 (SF-36) scores at different time intervals for the two subgroups-degenerative disc disease (DDD) and contained lumbar disc herniation (CLDH).

	Preoperative	Postoperative	6 months	1 year
Visual analogue scale (VAS) scores
DDD	6.4	3.08 (0.002)	3.41 (0.009)	3.7 (0.173)
CLDH	6.6	3.08 (0.002)	4.2 (0.01)	4.28 (0.041)
Oswestry Disability Index (ODI) scores
DDD	40.66	24.33 (0.003)	27.16(0.028)	26.28(0.091)
CLDH	45.66	22.16(0.002)	29.7(0.047)	28(0.128)
Short form-36 (SF-36) scores
DDD	42.91	-	39.4(0.357)	42.6(0.461)
CLDH	32.9	-	43.17(0.136)	43.25(0.102)

Figure in parentheses indicates p value when compared to the respective preoperative score. SF-36 scores were recorded only at 6 months and 1 year postoperatively.