Out-patient treatment provides long-term back pain relief

(Ivanhoe Newswire) -- A minimally invasive treatment called percutaneous disc decompression for painful herniated disc kept patients pain-free up to two years later.

Discs are sponge-like cushions that rest between the bones of the spine. When a disc bulges or herniates outward, it can cause irritation or pressure on the spinal nerves, resulting in a condition known as sciatica. Sciatica is characterized by back and leg pain and weakness. Physicians often prescribe weeks of anti-inflammatory and pain medications before considering other treatments.

"Most protocols call for a minimal approach to initially treat a herniated disc," Alexios Kelekis, M.D., Ph.D., assistant professor of interventional radiology at the University of Athens in Greece, was quoted as saying. "But by deflating the disc and giving the nerve root the space it needs, disc decompression solves the problem of root irritation and prevails in the long run."

In percutaneous disc decompression, interventional radiologists use image guidance to puncture a bulging disc through the skin with a needle and deflate the disc by either removing some tissue or using energy to dissolve it. The procedure is performed on an outpatient basis under local anesthesia, and patients are usually able to return to normal activities within 30 days.

In this study, Dr. Kelekis and colleagues treated two groups of patients with herniated discs and sciatica confirmed by MRI. Each group included 17 men and 14 women. The mean age of patients was 36.

Both groups had tried different conservative treatments without success. The first group, which received six weeks of rigorous conservative therapy consisting of analgesics, anti-inflammatory drugs and muscle relaxants, reported pain reduction and improved mobility at the end of treatment. The second group underwent percutaneous disc decompression.

Upon completion of treatment, patients in both groups were clinically evaluated and completed a questionnaire to assess pain relief, quality of life and mobility improvement at intervals of three months, 12 months and 24 months later.

Both patient groups reported pain reduction and increased mobility at the three-month interval. However, one year and two years after treatment, patients who had undergone disc decompression continued to improve, while patients who received only conservative therapy reported that their pain had returned and their mobility had decreased.

Up until 12 months following therapy, both groups of patients were doing great," said Dr. Kelekis. "But by 12 months beyond treatment, patients who received only conservative therapy had returned to their initial pain levels."

SOURCE:Presented at the annual meeting of the Radiological Society of North America (RSNA), Chicago, December 2, 2009

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