Clin J Pain. In a prospective, parallel, randomized and gender stratified, double-blind placebo-controlled study, Kvarstein et al (2009)evaluated the long-term effect and safety aspects of PIRFT with the discTRODE probe. 2012;15(2):E115-E129. Intradiscal electrothermal therapy is used to treat patients with chronic, nonspecific low back pain attributed to degenerative disc disease and who met the criteria for interbody fusion surgery. Kapural L, Ng A, Dalton J, et al. The efficacy of coblation nucleoplasty for protrusion of lumbar intervertebral disc at a two-year follow-up. Funayama T, Setojima Y, Shibao Y, et al. Ceylan A, Asik I, Ozgencil GE, Erken B. Desai MJ, Ollerenshaw J, Harrison R, et al. Saal JS, Saal JA. The limitations of this portion of the study were that the remaining IAS group sample size was not large enough to carry out statistical test-based comparisons between the originally treated C-RFA patients and the IAS group members at 12 months, outcomes of the originally treated C-RFA group and those of the crossed-over cohort could not be directly compared at 6 months, because the groups were derived from 2 different study populations, and an effect of C-RFA on opioid use could not be detected, perhaps due to alternate patient conditions that also utilized opioids as therapy. those with a contained lumbar disc herniation (CLDH) (n = 12). width: 100%; His pain was worse when the neck was held in one position for a prolonged period. There was at least 50 % improvement on the ODI at 1 month, 3, and 6 months after treatment, but not at 12 months. The literature was evaluated according to Cochrane Review criteria for RCTs and according to the Agency for Healthcare Research and Quality (AHRQ) criteria for observational studies. During the procedure, 4 patients from group B were excluded from the study. 2012;39(3):517-523. Bhagia et al (2006) reported the short-term side effects and complications after percutaneous disc decompression utilizing Coblation technology (Nucleoplasty). Five cases had post-operative discitisthat cleared clinically and radiologically within 2 months without sequelae in4 of them. Because the source of the pain is a compressive force caused by motion of the spinal vertebrae, various motions can cause the pain to flare up. Ina prospective, multi-center, randomized, controlled trial, Gersztenand colleagues (2010)assessed clinical outcomes with percutaneous plasma disc decompression (PDD) as compared with standard care using fluoroscopy-guided trans-foraminal epidural steroid injection (TFESI) over the course of 2 years. The mean NRS scores in the total cohort before intervention was 8.0, and was reduced to 4.3 in the DiscoGel group and 4.2 in the PLDD group after 12 months, which was statistically significant. In a prospective, multicenter pilot study, Kelekis et al (2021) compared the non-inferiority treatment status and clinical outcomes of intradiscal O2-O3 with microdiscectomy in patients with refractory radicular leg pain due to single-level contained lumbar disc herniations. Helm et al (2012) evaluated the effectiveness of TAPs in treating discogenicLBP and assessed complications associated with those procedures. Oxygen-ozone therapy for herniated lumbar disc in patients with subacute partial motor weakness due to nerve root compression. The procedure was performed under local anesthesia. The primary outcome was the proportion of individuals with greater than or equal to 50 % pain relief after intradiscal biologic injection at 6 months. 2020;5(4):264-271. padding-right: 18px; Asian Spine J. Eur Spine J. Based on the pain characteristics, and the result of discography, these investigators diagnosed him as having discogenic neck pain originating from C4 to C5. These researchers stated that although a clinically significant surgical avoidance rate for patients with herniated lumbar disc radiculopathy has not been established, confirming the high avoidance rate with intradiscal O2-O3 in this trial with larger, and longer follow-up clinical trials would provide additional valuable information. } 2007;149(5):495-500; discussion 500. The Disc Institute of Minnesota has one primary goal: to help you avoid back or neck surgery. The procedure involves placing a thermal catheter within an intervertebral disc via a 17-gauge introducer needle under fluoroscopic guidance and heating the tip to 90C over 13 minutes and maintaining that temperature for 4 minutes. After 36 months, only 6 patients progressed to surgery. No intra-operative and post-operative complications were reported. She underwent surgical drainage and irrigation. You might also feel weakness in the same places. Now you have a proven alternative to invasive procedures like surgery or epidural injections. Overgrowth of bone, tumor growth, or herniated discs can also lead to the development of spinal stenosis. We take what we do very serious and have had third party research done to validate our outcomes, which was published in a peer-reviewed medical journal.We are also pleased to announce that one of the co-author's of our research paper is a world famous neurosurgeon who was the head professor of . Side effects and complications after percutaneous disc decompression using coblation technology. Secondary outcome measures were improvements in functional status. Before and after treatment, disability was assessed by the Oswestry disability score. 2019;49(6):1634-1639. If you suffer from bulging, degenerative or herniated discs, and have been told you have to undergo spinal surgery or just live with the pain, The Disc Institute is here to help. They noted that further follow-up evaluation is underway to determine the durability of QOL improvement after Nucleoplasty. 2011;3(3):288-292. Pain Physician. The non-parametric Friedman statistical test was used to determine the possible differences between baseline and different follow-up time-points on pain reduction after treatment. The SpineWand is designed to relieve pressure on spinal nerves adjacent to the disc by removing disc material. Idk. IntraDiscNutrosis is a completely unique form of treatment that turns on the disc's self-repair process: it is not physical therapy, chiropractic care, pain management, or spinal surgery. 2008;8:80-95. A total of 22 patients who had undergone Nucleoplasty were included in the analysis. Functional status of ODI was 28.5 2.1 before intervention and showed significant reduction after 2 weeks (with the mean of 12.3), and it was almost sustained till 6th months after intervention, with the mean of 11.4 (p = 0.001). Reuters Health, May 8 2002. Additional validation of these positive results in placebo-controlled randomized trials and studies that compare IDET with alternative treatments is needed. } In a recent review, Barndes et al (2002) commented: "IDET is an innovative tool for the treatment of discogenic back pain. .strikeThrough { 2021 Dec 9 [Online ahead of print]. The Nerve & Disc Institute has helped lots of patients end the pain and get their life back. They go skiing. Discography was positive at C4 to C5. The Nerve & Disc Institute's IntraDiscNutrosis (using DiscLogix) treatment program is a medical breakthrough for people suffering from bulging discs, herniated discs, degenerative disc disease, stenosis, sciatica, and other disc-related symptoms. It is not physical therapy, chiropractic care, pain management, injections, or spinal surgery. }. These discs, which sit between each of the spinal vertebrae, are tough, jelly-like rings that protect the nerves traveling to and from the spinal cord itself as the spine compresses throughout the day. If this study demonstrated that this treatment is potentially safe and effective, and the methods and procedures used in this study are feasible, a RCT would follow. Pain Physician. Website looks a bit shady too. In patients 1 and 3, ODI improved from 24 to 8 and 10 points, respectively, and SF-36 physical function score changed from 55 to 80 and 45 to 82, respectively. In addition, the reference lists of all included studies were manually searched. Therefore, the interpretation of these findings should be considered with prudence. Spine J. Our patients have been in your shoes. Is VAX-D safe? All randomly assigned patients were included in the primary efficacy analysis. The chymopapain chemonucleolysis has the most publications, but it is also accompanied by the most significant adverse complications and so it is scored as a 2B+/-. Spine (Phila Pa 1976). In-vitro, these investigators found optimal needle artefacts of 1.5 to 5.0 mm for the PDw TSE sequence in all angles of the applicator system to B0. 2020;21(1):135. Nucleoplasty (also known as percutaneous radiofrequency thermomodulation or percutaneous plasma diskectomy) is a percutaneous method of decompressing herniated vertebral discs that uses radiofrequency energy (Coblation [ArthroCare Corp., Sunnyvale, CA]) for ablating soft tissue, and thermal energy for coagulating soft tissue, combining both approaches for partial disc removal. A total of 42 cases of protruded lumbar intervertebral disc treated by coblation Nucleoplasty followed-up for 2 years were analyzed. 702 - Section 8 & 15-Accepted And Acknowledged. Data were analyzed from 14 patients (8 men and 6 women; mean age of 33.8 years). Freeman BJ, Mehdian R. Intradiscal electrothermal therapy, percutaneous discectomy, and nucleoplasty: What is the current evidence? Zhang L, Zhang W, Hu Y, et al. Status. z-index: 99; A blinded interim analysis was performed when 20 patients had been followed for6 months. They were evaluated using the VAS, ODI and SF-36 scores pre-operatively and post-operatively. WMJ. The authors concluded that nucleoplasty and Dekompressor have a weak positive recommendation for the treatment of patients with lumbar radicular pain. Spine J. Pain relief was the primary outcome measure. The fat was separated to isolate the SVF and the cells were delivered into the disc nucleus of patients with DDD. Fifteen patients were responders at 1 month (88 %), 9 at 3 months (53 %), and 12 at 6 months (70.6 %). Kvarstein G, Mwe L, Indahl A, et al. Cochrane Database Syst Rev. These researchers stated that additional studies are needed to identify which subset of patients with discogenic LBP are most likely to experience the highest and most consistent benefits from this minimally invasive autologous therapy, and how effective this therapy is when compared to control therapies. The relevant literature for Nucleoplasty was identified through a search of the following databases: PubMed, Ovid Medline, and the Cochrane library, and by a review of the bibliographies of the included studies. This paradigm was consistent with the intention of the study to test C-RFA as a rescue intervention for knee OA, rather than long-standing, conservative IAS. Foot Pain: Are You Putting Your Best Foot Forward? color: red!important; 2000;25(20):2622-2627. 2017;11(3):380-389. Desai et al (2017) reported the 12-month outcomes of subjects treated with intra-discal biacuplasty (IDB) and conservative medical management (CMM) for chronic low-back pain (LBP) of discogenic origin, and results for subjects who elected to receive IDB + CMM 6 months after CMM-alone. Subjects and coordinators were blinded to randomization until 6 months. The objective of the study was to test the safety of IDET compared with sham treatment for low back pain of at least 3 months duration. The device is activated for 90 seconds at a temperature of 70 degrees Celsius. Summary. Pain Physician. color: #FFF; However, randomized controlled studies are needed to ascertain with more precision the role of this procedure. These investigators carried out comprehensive literature search in 2018 and updated in 2020. Validation of the initial reports of IDET in placebo-controlled randomized trials is needed. In additional, the evaluation tools in the study were externally-validated instruments and the internal validity related to reporting was unknown; however; the multi-variable indicators, both general and back pain specific, were implemented to counter-balance this drawback, and the outcome data demonstrated consistent improvements in pain, function, and quality of life, which provided credibility to these findings. Freeman et al (2005) reported on 57 patients who were randomized to either IDET (n = 38) or sham (n = 19). It is not chiropractic, physical therapy, pain management, or any other traditional method youve tried to relieve your pain. Two cooled RF electrodes placed in a bipolar manner in affected discs to lesion the nociceptive fibers of the annulus fibrosus. O2-O3 treatment performed as outpatient day surgeries, included a one-time intradiscal injection delivered at a concentration of 35 3 g/cc of O2-O3 by a calibrated delivery system. Third, currently, the research on silk scaffolds is still limited to animal experiments, and even large animals have relatively few studies. IntraDiscNutrosis is a completely unique form of treatment that turns on the disc's self-repair process; it is not physical therapy, chiropractic, pain management, epidural injections, or spinal surgery. } Of the 1,894 subjects screened, 64 subjects were enrolled, and 59 were treated: 29 randomized to IDB and 30 to sham. Rev. color:#eee; 2006) reported that the diagnosis of internal disc disruption was surrounded by controversy and that the effect of IDET was not well understood. Spinal stenosis can cause a number of annoying symptoms that can get worse over time. Because of unanswered questions about the durability of results and generalization of these findings, this single study is not sufficient to draw conclusions about the effect of IDET on health outcomes. 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