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Clinical efficacy and its prognostic factor of percutaneous endoscopic lumbar annuloplasty and nucleoplasty for treatment of patients with discogenic low back pain
Session: MP-04b
Thurs, April 19, 3:30-5:00 pm
Uris (Shubert Complex), 6th floor

Please note, medically challenging cases are removed three months after the meeting and scientific abstracts after three years.

Poster Presenter


Average: 5 (1 vote)

A randomized, double blind, multicenter trial to evaluate clinical effectiveness of 4.4 MHz-radiofrequency compared with ultrasound for patients with subacute low back pain

Jung Hwan Lee, MD, PhD1, Yong-Taek Lee, MD, PhD2, Hee-Jin Park, MD, PhD3, Jong Geol Do, MD2, Mi Hwa Kim, MS4, Jung Soo Won, BSc1, Sang-Ho Lee, MD, PhD5,  Eun Kyung Kim, MS4, Sang Jun Kim, MD, PhD4

1Department of Physical and Rehabilitation Medicine, Spine Health Wooridul Hospital, 2Department of Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine,  3Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine,  4Department of Physical and Rehabilitation Medicine, Stem Cell & Regenerative Medicine Institute, Samsung Medical Center, 5Department of Neurosurgery, Spine Health Wooridul Hospital 


Selecting the appropriate treatment for discogenic low back pain (DLBP) that cannot be controlled by conservatives is often difficult.

Because surgical techniques are invasive and can be associated with severe complications, a variety of alternative minimally invasive percutaneous intradiscal procedures have been attempted.

Percutaneous endoscopic lumbar annuloplasty and nucleoplasty (PELAN) is a minimally invasive treatment  for DLBP 


To identify the clinical efficacy of PELAN in treating patients with DLBP

To investigate the prognostic clinical or radiological variables.

Materials & Methods

PELAN was conducted by endoscopic catheter with laser equipment that was introduced through the cannula. Laser ablation was performed under direct visualization.


Evaluation of clinical improvement and success

Numeric rating scale (NRS) for back pain :  ≥ 50% reduction

Oswestry disability index(%) (ODI%) : ≥ 40% reduction

Modified MacNab criteria  : Excellent or Good

At short term(3-4 weeks) and long term follow up (at least 12 months)

Results & Discussion

NRS and ODI(%) were significantly reduced at short and long term follow up after PELAN.

62(69.7%) and 68(76.4%)  : successful NRS  at short & long

59(66.3%) and 68(76.4%) : successful ODI(%) at short & long

61% and 65.2%  : successful McNab  at short & long


Flexion pain was related to good clinical outcomes :  

   Flexion pain suggested DLBP, select good candidate of PELAN

Modic change related to poor clinical outcomes :

   It represented persistent inflammation of the end plate and metabolic changes of adjacent bone marrow that PELAN could not treat



PELAN provided favorable clinical outcomes in DLBP.

Flexion pain was  good  prognostic factor.

Modic changes was poor prognostic factor.

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