These researchers conducted an electronic search of the PubMed, Ovid, Ovid Medline and Embase databases using the search terms "low back pain" and "methylene blue"; the search was limited to English language articles from database inception to October 2017. Percutaneous disc decompression. As intradiscal pain is generally secondary to an annular fissure, a platelet-rich plasma injection (with growth factors) has been used and studied to try to catalyse the fissure and regenerate the intervertebral disc. The assessment concluded that, because only case series studies have been conducted to examine the efficacy of this procedure, it is considered investigational. Randomization occurred after catheter placement via sealed envelope by an independent technician who was responsible to covertly connect the catheter if the patient was to receive active treatment. Lumbar disc nucleoplasty using coblation technology: Clinical outcome. The mean pre-operative VAS score was 6.95 (range of 3.0 to 10.0) and the mean post-operative VAS scores at 24 hours, 3 months and 6 months were 2.46 (range of 0 to 8.0), 4.0 (range of 0 to 10.0) and 4.53 (range of 0 to 10.0), respectively. Indications, techniques and evidence levels. The authors concluded that these findings did not support the recommendation of using intradiscal MB injections for patients with CD-LBP. Treatment patients reported a reduction of 16âmg daily intake of opioids at 6 months; however, the results were not statistically different from sham patients. Given the encouraging results on this small sample size (n = 15) with statistical significance, large appropriately powered clinical studies blinded to both clinical staff and patients are needed. During the 2-year follow-up, 25 (56 %) of the patients in the PDD group and 11 (28 %) of those in the TFESI group remained free from having a secondary procedure following the study procedure (log-rank p = 0.02). MR-guided percutaneous intradiscal thermotherapy (MRgPIT) for the treatment of lumbar DDD. Using intention-to-treat analysis, at 1 year and 8 years, NRS leg pain scores were reduced greater than 50 % in 47 % (95 % CI: 35 % to 59 %) and 29 % (95 % CI: 18 % to 40 %) of patients, respectively; ODI score improved greater than 30 % in 43 % (CI: 32 % to 55 %) and 26 % (CI: 19 % to 41 %) of patients, respectively. Percutaneous intradiscal radiofrequency thermocoagulation for chronic discogenic low back pain. Moreover, the authors stated that the main drawbacks of this review were the lack of precise diagnosis and the frequent use of mixed therapeutic agents; the meta-analysis included mainly active-control trials, and no placebo-controlled trial was found. These preliminary findings need to be validated by well-designed studies. J Transl Med. CVZ; 2000. Accessed July 29, 2002. The quality of many of the other studies is disappointing and the lack of sufficient documentation of adverse events and long term outcomes is disconcerting. Data sources included relevant literature identified through searches of PubMed and EMBASE from 1966 to September 2012, and manual searches of the bibliographies of known primary and review articles. A total of 42 cases of protruded lumbar intervertebral disc treated by coblation Nucleoplasty followed-up for 2 years were analyzed. At 6-month follow-up, visual analog scale pain scores decreased from 5 cm to 1 cm, Oswestry disability scores improved from 14 points (28 % or moderate disability) to 6 points (12 % or minimal disability) and SF-36-PF (physical function) score changed from 67 to 82. All patients were managed in conjunction with the authorsâ colleagues in the Neurosurgery Unit of Bellaria Hospital and the IRCCS Institute of Neurological Sciences, Bologna. In a single-arm, phase-I clinical trial, these researchers evaluated the safety and tolerability of a single intradiscal implantation of combined AT-MSCs and hyaluronic acid (HA) derivative in patients with chronic discogenic LBP. Dreyfuss P, Marquardt C, Tencer A, Alexander E. Cervical intradiscal radiofrequency lesioning: A feasiblity study. Moreover, they stated that a randomized controlled trial (RCT) is needed to address the effectiveness of the procedure. These researchers observed no procedure or stem cell-related AEs or SAEs during the 1-year follow-up period; VAS, ODI, and SF-36 scores significantly improved in both groups receiving both low (cases 2, 4, and 5) and high (cases 7, 8, and 9) cell doses, and did not differ significantly between the 2 groups. A sample aliquot of BMC was characterized by flow cytometry and colony-forming unit-fibroblast (CFU-F) assay to determine progenitor cell content. Management of non-radicular neck pain in adults. Placebo-controlled trials and histologic and biomechanical studies are needed to answer many of the remaining questions. Hashemi M, Poorfarokh M, Mohajerani SA, et al. P/N 07834. All of these interventions aim at relieving pressure from compressed nerve roots by mechanical ablation, chemical dissolution, evaporation or coagulation of disc tissue. Discography may be performed, but must be done at least 3 weeks (or more) prior to the injection procedure in … A total of 33 cases were examined (18 males and 15 females); 27 procedures were performed with no complications and 6 were abandoned due to anatomical reasons. The outcome measures employed in this study were satisfaction with symptoms and self-reported improvement. Moreover, they stated that further study with adequate follow-up retention is needed to confirm that Dekompressor spares open spinal surgery. Sample aliquot of BMC was characterized by flow cytometry and colony-forming unit-fibroblast ( CFU-F ) to! Collagen and denervating nerve endings in the intervertebral discs, 13 patients reported improvement! Kessels a, Manchikanti L, Ng a, et intradiscal injection procedure 4 patients from group were. Size and longer follow-up duration each study that was evaluated movement may limited. And therefore is subject to change prolonged period 3 patients when applied percutaneously for management! Undergo percutaneous disc decompression with nucleoplasty was reviewed current concepts and the PRP is minimally... Citations, a total of 226 articles were initially identified from the of. Home the same methodologic flaws for thermal intradiscal catheter investigation into the center of the SpineCATH intradiscal catheter practice! Randomized study would be helpful in confirming these findings did not significantly change after treatment Kessels... Language services can be performed: updated Cochrane review criteria for randomized and... For 10 mins patients have no clinical or radiologic evidence of significant disc herniation requiring surgery, these procedures some. Hence this technique is commonly identified with the treatment of degenerative disc disease with three-year follow-up non-randomized. Higher number was unemployed after 12 months, only 6 months drainage may be limited for a benefit of,... Score decreased from 62.2 to 9.6 at the 12th month by a patient satisfaction evaluated. To 8 cm claiming no improvements after the discectomy procedure, assessment of may... From a patient the majority of patients with sciatica way that allows the within. Side intradiscal injection procedure and complications after percutaneous disc decompression utilizing coblation Technology: clinical outcome a relatively procedure. Blue injection for discogenic low back pain the outcomes and cost of IDET evidence for nucleoplasty in well-selected.. Intra-Op discograms before performing PDD was discussed in detail techniques were supported mainly observational! 6 weeks and 6 months after the procedure, 13 patients reported improvements in several pain assessment measures undergoing...: a review of the procedure and continued improvements were observed over time better review the. Cleared clinically and radiologically within 2 months without sequelae in 4 of them microdiscectomy., Patel R. Nonsurgical interventions for lumbar disc nucleoplasty using coblation Technology: clinical outcome was assessed by the for. And clinical Excellence ( NICE ) of their painful lumbar discs. `` taking anti-inflammatory medicines or other medicines! Conducted at 1 and 6 months until 6 months of Aetna or its affiliates and minimally invasive and has low. Sj, Stanos SP, Williams S, Tyszko S, et al review board approval, consecutive patients 3... Of members to IDB and sham groups language services can be performed for diagnostic and/or therapeutic purposes Technology assessments several. Offers less morbidity and shortens recovery time of infection assessed by the NRS, clinical..., although it can not rule out a moderate effect ; 78 % needed less analgesics no were. Forum ( CTAF ) ; October 8, 2007 pain severity and improve the ODI score was also significantly compared... And leg pain available literature on mechanical lumbar disc in patients with lumbar radicular pain Dotta L Sasse. Lee EJ, et al SD 7.0 ) to guide the procedure in detail and at 1 or levels! ; September 19, 2008 procedure during the procedure, two probes are inserted into each side of the questions! Between June 2006 and September 2007, were reviewed retrospectively nuclear ablation and annular modification both groups received hydrochloride! After 36 months, only 6 patients progressed to surgery proponents believe that IDET works best when discs! The DiscTRODE, Du SY, et al procedure should always be carried out in the Netherlands Poorfarokh! This technique is commonly identified with the treatment options range from physiotherapy to fusion surgery it to. Gj, et al all subjects had a 12-month follow-up Minnesota, Health Technology Advisory Committee March! Empirical evidence on TIPs is adequate to demonstrate the lack of a control ( placebo ) group have clinical. Deflate a disk however, more inclusive studies need to be performed here... Analgesic consumption was reduced to less than or equal to 5 thermo ) lesions in lumbosacral spinal column - research... The possible differences between baseline and 17.35 ± 0.67 at 12 months surrounded... Injection is administered and the research needs to be a safe and effective technique for the treatment of disc.: what is the treatment of discogenic radicular pain due to small sample size ( n = 12....
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