Efficacy and safety of nucleo-annuloplasty using radiofrequency ablation for discogenic back pain in a local Hong Kong population

Purpose: Degenerative disk disease is a global and common debilitating condition with substantial healthcare and economic costs. Disc-Fx is a relatively new minimally invasive, percutaneous nucleo-annuloplasty procedure aimed to alleviate symptoms of discogenic back pain via manual discectomy with nuclear and annular modification via means of radiofrequency ablation. The aim of this retrospective study is to report the 1-year outcomes, efficacy and safety of the percutaneous nucleo-annuloplasty procedure for treatment of discogenic back pain in the local Hong Kong population. Methods: This retrospective study consists of 16 patients with a total of 24 levels from 2017 to –2019 with at least 6 months of chronic back pain failing conservative management, MRI-confirmed disc degeneration, and who have undergone percutaneous nucleo-annuloplasty via Disc-Fx procedure. All patients had plain radiography and magnetic resonance imaging prior to procedure. Percutaneous nucleo-annuloplasty was only performed in patients with confirmed discogenic back pain via a positive provocative test on discography. Results: The mean functional outcome of Oswestry Disability Index improved from 46.25 points preoperatively to 24.12 at the of 1-year follow-up (p-value = 0.00). The Numerical Pain Rating Scale improved from 6.25 points to 4.4 points (p-value: 0.01) and 14.56 points to 8.85 points (p-value = 0.01) at preoperative to 1-year post-procedure respectively. There were no reported procedural related complications in the study population. Conclusion: The procedure of percutaneous nucleo-annuloplasty shows to be a relatively safe procedure that can be considered in patients with discogenic back pain. Larger studies would be desired to draw further conclusions about its efficacy.