Management Of Discogenic Low Back Pain With Intradiscal Electrothermal Therapy Or Microendoscopic Discectomy/Interbody Fusion: A Retrospective Study Of 48 Cases

This study was to evaluate the outcome of intradiscal electrothermal therapy (IDET) and microendoscopic discectomy (MED)/interbody fusion for discogenic low back pain. Forty-eight patients with symptoms of discogenic low back pain and treated with IDET or MED between April 2003 and May 2011 were enrolled in the study. The Degree of annular disruption was evaluated according to "Modified Dallas Discogram Description" method. The patients with Degree II annular disruption were performed with IDET; the patients with Grade III annular disruption and level III-IV of annular degeneration were treated with MED/interbody fusion. All patients were followed up on a regular basis. The treatment outcome was evaluated by visual analogue scale (VAS) and oswestry disability index (ODI) scores. There were 14 cases of Degree II annular disruption and 34 cases with Degree III annular disruption. The patients were followed-up with an average of 50 (range, 1-72) months. Of the 14 cases treated with IDET, the average VAS score of 13 cases at the final follow-up reduced significantly compared with preoperatively (P<0.01). Of the 34 patients treated with MED/interbody fusion, 32 cases showed obvious VAS score decrease at the final follow-up with statistical difference compared with preoperatively. The ODI scores of the 48 cases at the final follow-up had significant difference (P<0.01) comparing with preoperatively. In conclusion, a significant improvement was obtained in patients with chronic discogenic low back pain treated with IDET or MED/interbody fusion. A prospective randomized control study with a large sample is needed.