Abstract ID: A28
Abstract Title: Percutaneous Disc Decompression: Initial Efficacy & Safety Data
Poster Type: Poster
ABSTRACT BODY
INTRODUCTION:
Low back pain affects 70 to 80% of adults at some point during their lifetime. 39% of cases of chronic low back pain are estimated to be of discogenic etiology. Percutaenous disc decompression (PDD) using the Viking catheter is a recent advance in minimally invasive treatment of persistent discogenic pain. The aim of this pilot study is to obtain preliminary data on the efficacy and safety of PDD.
METHODS:
After IRB approval, all subjects who underwent PDD from 11/02 to 2/04 were restrospectively studied. Subjects had failed conservative medical and interventional therapies. One subject with ongoing litigation was excluded. Response to treatment was determined by 2 methods: an 11 point numeric scale (0-10) labeled on a horizontal line marked by patients at each clinic visit and a descriptive response based on the patient and physician documented responses. The records were examined for complications and specifically for infection, bleeding, neurologic abnormalities, and duration of each event.
RESULTS:
10 subjects qualified for the study (7F, 3M), mean age 44.5, age range 25-60, median pain duration 2-5 yrs.
80% of subjects reported a decrease in pain scores within 2 weeks of treatment. Pain reduction was sustained for the 4-month duration of the study. Median reduction in pain scores were 4.5 points at month-1 and 5.5 points at months-2, -3, and -4. 85% reduction in pain scores at month-4. At four months 8 of 10 subjects reported ≥5 point reduction in pain scores; 7 of these 8 subjects reported an excellent outcome and one reported a fair outcome.
There was only one complication, a report of transient dysesthesia in a radicular distribution, which resolved within 5 days post-op. This subject had reported presence of intermittent numbness and dysesthesias preoperatively. There were no reports of intra-operative paresthesias during her treatment. Therefore it is not clear if this was a result of the procedure or simply a recurrence of her usual preoperative symptoms.
CONCLUSION:
The current pilot study demonstrates an 80% short-term success rate for PDD with an excellent safety profile. This success rate compares favorably with historical data on surgical and non-surgical therapies for discogenic pain. The prompt onset of pain relief is a dramatic improvement relative to older minimally invasive devices available for treatment of discogenic pain. Current data supports further prospective analysis of this therapy.
ATTACHED FILES
A28_PDD Graph.doc
Reg Anesth Pain Med 2004; 29(2):A28