Assessing the Impact of Percutaneous Minimally Invasive Intradiscal Procedures in Chronic Low Back Pain

Abstract

The prevalence of chronic low back pain (CLBP) worldwide is estimated to be 11.9% and in most of the cases is nonspecific (85%). Persistent low back pain may originate from lumbar intervertebral discs, facet joints, and sacroiliac joints. Common causes of discogenic pain detected in magnetic resonance imaging include annular disc extrusion, disc herniation, disc tear, spinal canal narrowing, lateral recess narrowing, neural foramen compression, facet arthropathy, and ligamentum flavum thickening. Management of CLBP includes conservative treatment (oral analgesics, physical therapy, chiropractic care, and acupuncture), minimally invasive procedures, and surgical treatment. However, surgery may be associated with postoperative complications in 17%–18% cases, out of which reintervention is required in 6%–22% cases, and in 20% cases, may develop failed back surgery syndrome. In this case series, we assessed the effectiveness of minimally invasive procedures, such as biacuplasty and intradiscal steroid injection, over 28 days in three patients with CLBP and a Numerical Rating Scale pain score >4 despite conservative treatment and analgesics. We found significant improvement in pain severity and a decrease in analgesic requirements in all three patients.