Background: Percutaneous lumbar nucleoplasty (PLN) is an effective treatment for internal disc disruption (IDD). In this retrospective study, we evaluated the effectiveness of PLN to manage discogenic low back pain (LBP) and predictive factors associated with the successful outcome of PLN.
Methods: PLN guided by fluoroscopy was conducted for discogenic LBP by two pain physicians. Successful outcome was defined as more than 50% pain relief on the numerical rating scale (NRS) pain score, no increase in analgesics, and no additional treatment during the 6-month follow-up period. The relationship between outcomes and independent variables, including patient demographics, comorbid diseases, pain duration, numbers and level of the affected disc, the Modified Dallas Discogram Scale, preoperative MRI findings, and type of PCN needle were investigated using multivariable analyses.
Results: Of 98 patients, 64 experienced a successful outcome after PLN. In the positive outcome group, litigation status, higher Modified Dallas Discogram Scale, and type of PCN needle were reported. Multivariable analyses revealed that higher Modified Dallas Discogram Scale (P = 0.048) was a positive predictor. No serious complications related to PCN occurred.
Conclusions: In this study, 68.1% of the included patients showed more than 50% pain reduction without any complications during the 6-month follow-up period. The high-grade Modified Dallas Discogram Scale was a positive predictor for successful PLN.