Intradiscal Biacluplasty Effective for Discogenic Lumbar Back Pain

NATIONAL HARBOR — A minimally invasive technique called intradiscal biacluplasty that involves using cooled radiofrequency to destroy nociceptive nerves in degenerative spinal discs had a better treatment response among patients with discogenic lumbar back pain than conservative therapy.

“The taxing nature, recovery period and potential for complications associated with surgery for managing discogenic lumbar back pain make it important to avoid such treatments,” Mehul Desai, MD, of the George Washington University Hospital in Washington, D.C., said during a poster session at the American Academy of Pain Medicine 2015 meeting.

So he and colleagues compared outcomes for 29 patients who underwent intradiscal biacluplasty (IDB) and 34 control patients assigned to physician-prescribed conservative therapy, which consisted of medical management, physical therapy or lifestyle changes.

They assessed 6-month post-treatment outcomes on several assessment tools including the visual analog scale (VAS), SF36-physical functioning (SF36-PF), Oswestry Disability Index (ODI), Beck’s Depression Inventory (BDI), patients’ global impression of change (PGIC), and health-related quality of life (EQ-5D VAS).

Patients in the IDB group experienced greater reductions in mean VAS scores than those who underwent conservative therapy (-2.4 vs. -0.56; P=0.02), the researchers found, and the proportion of treatment responders who experienced a 30% decrease in VAS was also substantially larger in the IDB group — 50% vs. 18%.

Outcomes on the SF36-PF, ODI and PGIC scores also favored IDB and score changes in the BDI and EQ-5D VAS showed greater trends of improved health in the IDB group, the researchers reported.

“The superior preformance of IDB with respect to all study outcomes suggests that it is a more effective treatment for discogenic lumbar back pain than conservative therapy,” Desai said.