03:09 PM WITHDRAWN Abstract No. 200 Percutaneous thermal disc decompression versus percutaneous disc decompression like minimally invasive outpatient procedure of low back pain treatment: single-center one-year eperience

Abstract

The aim of our work is to compare two different minimally invasive, outpatient procedure for the treatment of contained lumbar disc protrusions using Percutaneous Targeted Disc Decompression (TDD) vs Percutaneous Disc Decompression (PDD) in patients presenting contained lumbar disc herniation confirmed with MR imaging. We enrolled 200 Patients with back and leg pain due to MRI identified unilateral and con-tained lumbar disc protrusion, who failed conservative treatment like physical and pharma-cological therapy or epidural steroid injections. Selected Patients were randomized into two group and treated with TDD (Group A) and with PDD (Group B); all procedures were performed under fluoroscopic guidance using a posterolateral approach contralateral or ipsilateral respect to the herniation. Group A completed a 12-minute 40° C thermal decompression protocol. Group B completed a standard mechanical decompression protocol. All group patients follow 1 month sessions of specific physical therapy. MRI and clinical follow-up measures were performed at 6 and 12 months and compared with PairTtest. Each patient has joined the procedure after written informed consent Group A: 100 pt received single-level treatment; 13 patients need for double-levels treat-ment. Group B: 100 pt received single-level treatment; 21 patients need for double-levels treat-ment. All patients were compliant with post-treatment protocol and follow-up. 6 months follow up: Group A mean improvement 3.9 on the VAS and 75% subjective improvement; Group B mean improvement 4.1 on the VAS and 77% subjective improvement; 12 months follow up: GroupA mean improvement 3.7 on the VAS and 86% subjective improvement; Group B mean improvement 3.9 on the VAS and 89% subjective improvement; Post 12 months follow up show that 89% of patients returned to work following treatment, about 7% make a discontinued use of medical therapy and only less than 4% required fur-ther pain retreatment. More than 95% of all treated patients were agree in repeating the procedure. One case of spondylodiscitis was observed. Both approaches appears to be a safe and effective treatment for chronic low back pain due to contained lumbar disc