Sharps L. Percutaneous disc decompression using Nucleoplasty. It can be difficult to determine who will benefit from spinal decompression surgery. 2010;10(6):560-579. IDET was introduced in 1997 and case series without controls have reported encouraging results. 2008;9(1):60-67. This trial was carried out in 3 European hospital spine centers. When there is irritation or pressure on this nerve (from a herniated disc for example), it is called sciatica, and causes many different symptoms. Several techniques have been introduced. Using current criteria for successful outcomes, the evidence is fair for IDET and poor for discTRODE and biacuplasty procedures regarding whether they are effective in relieving discogenic LBP. These researchers stated that high quality explanatory trials are needed to better examine the true effectiveness of these treatments. Airaksinen O, Brox JI, Cedraschi C, et al. New comments cannot be posted and votes cannot be cast. In addition, the lack of a comparison group for conservative therapies in the course of symptoms was another drawback for which future multi-center studies with comparison groups are recommended to further ascertain the safety, efficacy, and effectiveness of PLDD and intradiscal injection of DiscoGel in discopathy. Any case studies, results, endorsements, or testimonials presented on this page reflect the personal experience and opinions of the individual patient and do not prove our treatment works. The above policy is based on the following references: Last Review Database of Abstracts of Reviews of Effects (DARE). 2017;41(10):2097-2103. The grading of recommendation was 1C for intradiscal ozone therapy and 1B for paravertebral ozone therapy. IntraDiscNutrosis is a completely unique form of treatment that turns on the disc's self-repair process: it is not physical therapy, chiropractic, pain management, epidural injections, or spinal surgery. Nucleoplasty with or without intradiscal electrothermal therapy (IDET) as a treatment for lumbar herniated disc. There were no complications with the procedure. 2012;39(3):517-523. Streitparth and Disch (2015) stated that over the last decades a number of different minimally invasive interventions have been proposed for the treatment of intervertebral disc herniation and degeneration. In a retrospective, single-center study, Park and colleagues (2019) compared the therapeutic success of RF (an intradiscal procedure) and laser annuloplasty (both an intradiscal and extradiscal procedure). Harefuah. Intradiscal electrothermal therapy is minimally invasive and has a low complication rate and therefore might offer advantages over surgery. Ogbonnayaand colleagues(2013) evaluated the effectiveness of nucleoplasty in the management of discogenic radicular pain. The objective of the study was to test the safety of IDET compared with sham treatment for low back pain of at least 3 months duration. The lack of data makes it difficult to draw conclusions regarding the efficacy of the procedure. border: none; Mean post-treatment pain scores at months 1 and 6 were significantly lower (p < 0.01) in both groups, and between-group differences were not significant. A prospective, randomized, multi-center, open-label clinical trial comparing intradiscal biacuplasty to conventional medical management for discogenic lumbar back pain. Percutaneous disc decompression. Accessed January 15, 2002. The targeted patients have no clinical or radiologic evidence of significant disc herniation or nerve root compression. Banken R. Intradiscal electrothermal therapy for discogenic low back pain. The main drawbacks of this study were its small sample size (n = 18 in the DiscoGel group) and the sort-term follow-up (12 months). Intra-discal biacuplasty was performed under fluoroscopy using 2 RF probes positioned bilaterally in the intervertebral disc. Though the pain is sometimes just a manageable inconvenience, more often than not it can be debilitating, severely decreasing quality of life. Spine J. In recent years, due to improved extraction techniques, remarkable biocompatibility, excellent mechanical properties, well-controlled biodegradation rate, and the potential of multitudinous functional modifications, silk has become one of the most prevalent polymeric biomaterials in the regenerative medicine field to-date. 2016;17(6):1010-1022. After 2 weeks, it was reduced to 3.2 0.6 (p < 0.001) and finally dropped to 2.0 0.6 6 months after intervention (p = 0.0001). The heat energy applied through the coil causes the disc to shrink, thereby reducing discal pressure. Experts discuss the effectiveness of a back pain treatment that offers an alternative to surgery. These researchers stated that additional studies are needed to identify which subset of patients with discogenic LBP are most likely to experience the highest and most consistent benefits from this minimally invasive autologous therapy, and how effective this therapy is when compared to control therapies. The authors supported the use of thermal annular procedure in selected patients despite the fact that the level of evidence was low. Disc nucleoplasty (also known as percutaneous radiofrequency thermomodulation, percutaneous plasma discectomy or plasma disc decompression [PDD]) is a minimally invasive procedure to treat individuals with symptomatic low back and leg pain caused by herniated discs. The limitations of this systematic review included the paucity of literature and non-availability of 2RCTs which are in progress for biacuplasty. Call now to see if you qualify for this unique treatment program. The procedure utilizes a device called the ArthroCare Perc-D SpineWand, which includes the Perc DLR (designed to be used in larger discs), the Perc DLG (used when longer access is needed) and the Perc DC (designed to be used in the cervical portion of the spine). 2018;46(6):2461-2465. In a systematic review, these researchers examined the latest research on silk scaffolds in musculoskeletal TE applications within the past decade. You might experience numbness or tingling in the extremities. A critique of this systematic evidence review by the Centre for Review and Dissemination (2010) noted that theresults were mainly extracted from observational studies in settings where the studied procedure was performed routinely; hence there was a bias risk in favor of the procedure (this limitation was acknowledged by the authors). Status Refresh. The studies out there are not high quality," says Daniel J. Mazanec, MD, a spine specialist with the Cleveland Clinic. All subjects had a history of chronic LBP for longer than 6 months. Secondary outcome measures included treatment "responders", defined as the proportion of subjects with a 2-point or 30 % decrease in VAS scores. For example, in the process of tendon reconstruction, most of the scaffolds still do not reach the mechanical requirements of human daily life and exercise when compared with natural human tendons. San Francisco, CA: California Technology Assessment Forum (CTAF); October 8, 2003. 2001;82(1):120-122. Short-term effectiveness was defined as 1 year or less, whereas long-term effectiveness was defined as greater than 1 year. And you're not going to get the proper care and evaluation in a mill," Chemaly tells WebMD. Patients underwent a single intradiscal injection of combined HA derivative and AT-MSCs at a dose of 2107 cells/disc (n=5) or 4107 cells/disc (n=5). Centers for Medicare & Medicaid Services (CMS). Your disc has built-in mechanisms to repair itself, and IntraDiscNutrosis gets them working again. Chiropractic and Osteopathy, 2007. For additional language assistance: Injection(s), platelet rich plasma, any site, including image guidance, harvesting and preparation when performed, Injection(s), autologous white blood cell concentrate (autologous protein solution), any site, including image guidance, harvesting and preparation, when performed, Percutaneous injection of allogeneic cellular and/or tissue-based product, intervertebral disc, unilateral or bilateral injection, with fluoroscopic guidance, lumbar; first level, Percutaneous injection of allogeneic cellular and/or tissue-based product, intervertebral disc, unilateral or bilateral injection, with fluoroscopic guidance, lumbar; each additional level (List separately in addition to code for primary procedure), Percutaneous injection of allogeneic cellular and/or tissue-based product, intervertebral disc, unilateral or bilateral injection, with CT guidance, lumbar; first level, Percutaneous injection of allogeneic cellular and/or tissue-based product, intervertebral disc, unilateral or bilateral injection, with CT guidance, lumbar; each additional level (List separately in addition to code for primary procedure), Percutaneous intradiscal electrothermal annuloplasty, unilateral or bilateral including fluoroscopic guidance; single level, one or more additional levels (List separately in addition to code for primary procedure), Decompression procedure, percutaneous, of nucleus pulposus of intervertebral disc, any method, single or multiple levels, lumbar (e.g., manual or automated percutaneous discectomy, percutaneous laser discectomy, Magnetic resonance imaging guidance for needle placement (eg, for biopsy, needle aspiration, injection, or placement of localization device) radiological supervision and interpretation, Magnetic resonance imaging guidance for, and monitoring of, parenchymal tissue ablation, Autologous platelet rich plasma for non-diabetic chronic wounds/ulcers, including phlebotomy, centrifugation, and all other preparatory procedures, administration and dressings, per treatment, Cord blood-derived stem-cell transplantation, allogeneic, Bone marrow or blood-derived stem cells (peripheral or umbilical), allogeneic or autologous, harvesting, transplantation, and related complications; including: pheresis and cell preparation/storage; marrow ablative therapy; drugs, supplies, hospitalization with outpatient follow-up; medical/surgical, diagnostic, emergency, and rehabilitative services; and the number of days of pre-and post-transplant care in the global definition, Decompression procedure, percutaneous, of nucleus pulposus of intervertebral disc, using radiofrequency energy, single or multiple levels, lumbar, Other specified disorders of synovium and tendon, other site, Postlaminectomy syndrome, not elsewhere classified, Annulo-nucleoplasty (The Disc-FX procedure), Cervical intradiscal radiofrequency lesioning, Coblation percutaneous disc decompression, Intradiscal biacuplasty (IDB)/intervertebral disc biacuplasty/cooled radiofrequency, Intradiscal electrothermal annuloplasty (IEA), Intradiscal electrothermal therapy (IDET), Intradiscal pulsed radiofrequency for the treatment of discogenic neck pain, MR-guided percutaneous intradiscal thermotherapy (MRgPIT) for the treatment of lumbar DDD, Nucleoplasty (also known as percutaneous radiofrequency thermomodulation or percutaneous plasma diskectomy), Percutaneous (or plasma) disc decompression (PDD), Percutaneous intradiscal radiofrequency thermocoagulation (PIRFT)/intradiscal radiofrequency thermomodulation/percutaneous radiofrequency thermomodulation, Intradiscal glucocorticoid injection for the treatment of low back pain (LBP), Intradiscal implantation of combined autologous adipose-derived mesenchymal stem cells and hyaluronic acid for the treatment of discogenicLBP, Intradiscal implantation of stromal vascular fraction plus platelet-rich plasma for the treatment of degenerative disc disease (DDD), Intradiscal infiltration with plasma rich in growth factors for the treatment ofLBP, Intradiscal injection of autologous bone marrow concentrate for the treatment of DDD, Intradiscal injections of bone marrow aspirate for the treatment for discogenic LBP, Intradiscal injection of chondroitin sulfate ABC endolyase (condoliase) for lumbar disc herniation, Intradiscal injection of gelified ethanol (DiscoGel) for the treatment of cervical disc herniations, neck pain, and LBP, Intradiscal injection of recombinant human growth and differentiation factor-5 for chronic LBP, Intradiscal injection of hydrogel (GelStix) for the treatment of lumbar DDD, Intradiscal injection of methylene blue for the treatment of LBP, Intradiscal injection of platelet-rich plasma for discogenic LBP. The difference between O2-O3 and microdiscectomy did not exceed the non-inferiority 95 % confidence lower limit of treatment difference in either the AT (95 % lower limit, -1.72) or ITT (95 % lower limit, -1.13) populations. The authors concluded that although Nucleoplasty appeared to be a safe minimally invasive procedure, the value of this new technique for the treatment of discogenic LBP remains as yet unproven. Wolff M, Shillington JM, Rathbone C, et al. In patient 1 VAS went from 7 to 8 cm claiming no improvements after the procedure. VAX-D Medical Technologies, manufacturer of VAX-D, recommends the treatment for people suffering from herniated or degenerated disks resulting in low back pain and/or sciatica. Moreover ,these researchers stated that future study should use the effect size or success rate demonstrated in this prospective study for power calculation. USPTO Trademarks The Disc Institute Of America, Llc Intradiscnutrosis Application #86323825. In an observational study, Zhang and colleagues (2016) examined the clinical outcomes and MRI changes of intradiscal methylene blue injection (MBI) for the treatment of discogenic LBP. Singh V. Percutaneous disc decompression using Nucleoplasty. Therefore, we propose that TIPs are not reasonable and necessary.". It is not physical therapy, chiropractic care, pain management, injections, or spinal surgery. Thanks. Statistical analysis was performed using Wilcoxon's signed-rank test. The pain reduction after the PRGF-Endoret injections showed a statistically significant drop from 8.4 1.1 before the treatment to 4 2.6, 1.7 2.3, and 0.8 1.7 at 1, 3, and 6 months after the treatment, respectively, with respect to all the time evaluations (p < 0.0001) except for the pain reduction between the 3rd and 6th month whose significance was lower (p < 0.05). For instance, a study on VAX-D published in a 1998 issue of Neurological Research reported a 71% success rate among the 778 subjects who underwent VAX-D treatment. This is the first I, or my family member, has heard of this place and seems like a better choice rather than surgery. The European Guidelines for the Management of Chronic Nonspecific Low Back Pain (Airaksinen et al. In fact, an independent study found that IntraDiscNutrsosis patients have a greater than 90% success rate. Intervertebral disc therapies for non-specific chronic low back pain: A systematic review and meta-analysis. list-style-type: lower-roman; A total of 49 patients (mean age of 40 years, 17 women/32 men) with a single-level contained lumbar disc herniation, radicular leg pain for more than 6 weeks, and resistant to medical management were randomized, 25 to intradiscal O2-O3 and 24 to microdiscectomy; 88 % (43 of 49) received their assigned treatment and constituted the as-treated (AT) population. In the future, more clinical trials of silk scaffolds with tissue specificity are needed to validate their clinical applications. 2002;3(3). Thanks. } Intradiscal electrothermal therapy (IDET), also known as intradiscal electrothermal annuloplasty (IDTA) or IEA, is a minimally invasive surgical procedure that uses a catheter and a flexible electrode that is inserted into the affected disc in order to heat the entire posterior edge of the annulus. Available at: http://www.nucleoplasty.com/dph/information/vijay_sing_poster_for_IITS.pdf. The assessment concluded that, because only case series studies have been conducted to examine the efficacy of this procedure, it is considered investigational. The evolution of TIPs involved the use of electrical and radiofrequency energy to apply or create heat within the disc to treat discogenic pain. The indicated level of evidence for long-term pain relief was II-3 for ozone therapy applied intradiscally and II-1 for ozone therapy applied paravertebrally. While the current study provided encouraging feasibility data regarding intradiscal stem cell treatment and suggested some clinical benefit of the SVF therapy in degenerative disc patients, these investigators stated that a true evaluation of safety and effectiveness would require larger phase II/III studies. The studies utilized sophisticated random . Results from 5 RCTs investigating methylene blue injection, steroid injection, ramus communicans ablation, IDET and biacuplasty favored intervention over sham therapy. Dekompressor and nucleoplasty have the best level of evidence with a score of 2B+. Ceylan A, Ak . } San Francisco, CA: CTAF; February 13, 2002. Chicago, IL: BCBSA; February 2004;18(19). Function of lower limb and daily living of patients were evaluated by the ODI. They stated that randomized, placebo-controlled trials are needed to further evaluate the effectiveness of this treatment. Conservative medical management (CMM) was not standardized and the physicians were allowed to treat their patients based on personal clinical preferences. Kwak SY, Chang MC. A randomized, double-blind, controlled trial intradiscal electrothermal therapy versus placebo for the treatment of chronic discogenic low back pain. Dyer tells his patients to engage only in walking during the month-long recovery process. National Institute for Health and Clinical Excellence (NICE). Clinical features and radiological findings were compared between these groups. Guo X, Ding W, Liu L, Yang S. Intradiscal methylene blue injection for discogenic low back pain: A meta-analysis. Literature on its role in the management of lumbar disc pathology is scarce. The investigators reviewed available databases to identify non-randomized controlled trials and randomized controlled trials on these techniques. The authors stated that the main drawback of this study was that the number of patients included, especially in cervical group (n = 16) was relatively low; larger cohort might show different results. National Horizon Scanning Centre (NHSC). 2012;15(3):E279-E304. Pain relief was the primary outcome measure. No AEs of intradiscal PRF stimulation were observed. Levi D, Horn S, Tyszko S, et al. These positive results should be validated in placebo-controlled randomized trials and studies that compare IDET with alternative treatments. Intradiscal glucocorticoid injection for patients with chronic low back pain associated with active discopathy: A randomized trial. The quality assessment and clinical relevance criteria utilized were the Cochrane Musculoskeletal Review Group criteria for interventional techniques for randomized trials, and the criteria developed by the Newcastle-Ottawa Scale criteria for observational studies. Based on the pain characteristics, and the result of discography, these investigators diagnosed him as having discogenic neck pain originating from C4 to C5. A total of 29 patients were included in the study, which took place between 2013 and 2017. Patients with positive diagnostic MBN blocks (greater than 75 % relief) were randomized to MBN C-RFA or T-RFA. 2006;85(1):6-13. intradiscnutrosis what is it Kapural L, Mekhail N. Novel intradiscal biacuplasty (IDB) for the treatment of lumbar discogenic pain. You may be unable to think of little else except finding relief. The authors concluded that this case report was the 1st to suggest that intradiscal condoliase injection could be a useful and novel conservative therapeutic option for the treatment of post-operative rec-LDH. 2019;19(1):118-129. The investigators reported that there were no intra- and post-operative complications, and significant improvements in patient functional capacity and pain scores were noted. We take what we do very serious and have had third party research done to validate our outcomes, which was published in a peer-reviewed medical journal.We are also pleased to announce that one of the co-author's of our research paper is a world famous neurosurgeon who was the head professor of . Dall'Olio and colleagues (2014) noted that intradiscal oxygen-ozone (O2-O3) chemonucleolysis has been used for the treatment for pain caused by protruding disc disease and nerve root compression due to bulging or herniated disc. FTC 16 CFR Part 255 Compliance Statement: Results not typical. The primary outcomes were treatment success defined as at least 30 % reduction in pain intensity and the Patients' Global Impression of Change 6 months after the intervention. These practices vary from clinic-to-clinic and patient-to-patient, which reflects real-world application, and even in a research setting it is challenging to maintain standardized protocols. These researchers examined the effectiveness of percutaneous intradiscal GelStix administration in patients with discogenic pain due to lumbar DDD who were unresponsive to conservative methods. Cellular analysis showed an average of 121 million total nucleated cells per ml, average CFU-F of 2,713/ml, and average CD34+ of 1.82 million/ml in the BMC. All of which can travel from the back to the buttocks and legs. The quality of evidence on effectiveness of intradiscal biologics was very low. After 36 months, only 6 patients progressed to surgery. The main drawback of this review was a paucity of literature with randomized trials. Copyright 2019 | THE DISC INSTITUTE OF PITTSBURGH, Proven Results with Before and After MRIs, FDA Cleared (approval not required because it is non-invasive and proven safe), Can Cause a 21% Increase in Spinal Fractures, Removes Healthy Spinal Supporting Bone to get to the Disc, Removes Bone Connecting Ligaments to get to the Disc, Minimally Invasive surgery is still invasive. IntraDiscNutrosis program; Koren Specific Technique; Manipulation for infant colic; Manipulation for internal (non-neuromusculoskeletal) disorders (Applied Kinesiology); Manipulation Under Anesthesia (see CPB 0204 - Manipulation Under General Anesthesia ); Moire Contourographic Analysis; Network Technique; Neural Organizational Technique; Anyone know of their reputation for helping clients? A total of 63 subjects with lumbar discogenic pain diagnosed via provocation discography were randomized to IDB + CMM (n=29) or CMM-alone (n=34). INTRADISCNUTROSIS. Short-term effectiveness was defined as 1-year or less and long-term effectiveness was defined as greater than 1-year. outline: none; Kirchner F, Anitua E. Intradiscal and intra-articular facet infiltrations with plasma rich in growth factors reduce pain in patients with chronic low back pain. Helm S, Hayek SM, Benyamin RM, Manchikanti L. Systematic review of the effectiveness of thermal annular procedures in treating discogenic low back pain. /* aetna.com standards styles for templates */ These researchers observed no procedure or stem cell-related AEs or SAEs during the 1-year follow-up period; VAS, ODI, and SF-36 scores significantly improved in both groups receiving both low (cases 2, 4, and 5) and high (cases 7, 8, and 9) cell doses, and did not differ significantly between the 2 groups. A total of 15 patients, 22 to 55 years old, underwent 1- or 2-level IDB treatment of their painful lumbar discs. Daily opioid use did not change significantly from baseline: from 40 (95 % CI: 40 to 120) before IDB to 5 (0 to 40) mg of morphine sulfate equivalent 6 months after IDB. 2008;8:80-95. Typically they're less obese, have less [spinal] degeneration going on, more abdominal strength and better flexibility," he says. The groups did not differ in LBP intensity at 12 months and in most secondary outcomes at 1 and 12 months. Effectiveness of thermal annular procedures in treating discogenic low back pain. Radiographic disc height was assessed for 7 patients. Baylis TransDiscal System. These researchers stated that a large, double-blinded, randomized study would be helpful in confirming these findings. 510(k) No. Current literature from the VAX-D manufacturer states that "not one single injury has been sustained by a patient." intradiscnutrosis what is it This is a single blog caption. Pain Physician. Patients were also surveyed in regards to their pain medication use, and functional status was quantified by a physical therapist who also used patient reports of ability to perform activities of daily living to assess status. The lack of long-term and comparative data also makes it difficult to distinguish between the treatment effect and the natural history of the disease, as well as determine whether the benefits of this procedure are sustained beyond 12 months.". The authors stated that a randomized prospective study is needed. The bottom line, he said, is that more study is needed. Spine. Follow protocol for the recovery process. Functional and disability outcomes were also improved statistically and clinically; 55 % of the IDB + CMM patients responded to treatment with a mean VAS reduction of 2.2 points at 12 months. 2016;17(6):10231030. WebMD does not provide medical advice, diagnosis or treatment. There was a 1.7-point reduction (improvement) on a 7-point PGIC scale, and a 0.13-point increase (improvement) in the EQ-5D Health Index; 50 % of cross-over subjects responded to IDB + CMM intervention. This inflammation is typically the direct result of a damaged or herniated disc. "Younger patients do better. Use caution when choosing where to get treatment. However, results from the study on methylene blue injections have not been replicated in other RCTs. In post-hoc analyses, differences between treatment groups in improvement over baseline were compared at each follow-up visit, using baseline leg pain as a co-variate. Give The Disc Institute a call today to schedule your consultation and see if IntraDiscNutrosis is right for you. Spine. The authors concluded that these findings suggested that IDB is safe and effective; and indicated that IDB may fill an important niche as a minimally-invasive therapy to treat discogenic LBP in carefully selected patients. 2001;82(9):1230-1237. Clinical outcome was assessed by the VAS and Oswestry Disability Index Questionnaire. Reg Anesth Pain Med. A total of 5 studies were included. The following keywords and search terms were used: musculoskeletal, tendon, ligament, intervertebral disc, muscle, cartilage, bone, silk, and tissue engineering. Injection of intradiscal o2-o3 to reduce pain and disability of patients with low back pain due to prolapsed lumbar disk. A total of 42 cases of protruded lumbar intervertebral disc treated by coblation Nucleoplasty followed-up for 2 years were analyzed. The authors stated that this study was carried out in a Persian context, which limited the generalizability of findings since it may not be representative for other settings. The authors reported that no serious adverse events in either arm of the study occurred, without defining serious adverse events. Visual analog scale scores of patients were recorded in the pre-operative period and 24 hours, 3 months and 6 months after the procedure. In addition, you may need spinal fusion to stabilize your spine. Pain score and functional ability of the patients according to ODI were measured prior to the injection (baseline) and then at 2 and 4 weeks and then at 3 and 6 months after the injection. Percutaneous radiofrequency ablation for facet-mediated neck and back pain. An update of the systematic assessment of mechanical lumbar disc decompression with nucleoplasty. An acellular, bioresorbable, and good manufacturing practice (GMP)-compliant in situ-forming gel, which corrects discectomy-associated IVD defects and prevents further IVD degeneration had been developed. AAOS Online Service Fact Sheet. Canberra, ACT: MSAC; 2002. He explained everything and it finally made sense why my discs were going bad. Both groups successfully avoided spinal surgery. Secondary outcome measures were improvements in functional status. Safety and tolerability of intradiscal implantation of combined autologous adipose-derived mesenchymal stem cells and hyaluronic acid in patients with chronic discogenic low back pain: 1-year follow-up of a phase I study. California Technology Assessment Forum (CTAF). These include but are not limited to: prolonged sitting or standing, jerking motions such as those from sneezing and laughing, and bending backward. A greater than or equal to 15-point or greater than or equal to 30 % reduction in ODI score was observed in 62 % (95 % CI: 38 % to 82 %) and 44 % (95 % CI: 22 % to 69 %) of subjects in the C-RFA and T-RFA groups, respectively (p = 0.21). Kapural L, Ng A, Dalton J, et al. 2000;25(20):2601-2607. Nucleoplasty (also known as percutaneous radiofrequency thermomodulation or percutaneous plasma diskectomy) is a percutaneous method of decompressing herniated vertebral discs that uses radiofrequency energy (Coblation [ArthroCare Corp., Sunnyvale, CA]) for ablating soft tissue, and thermal energy for coagulating soft tissue, combining both approaches for partial disc removal. Clin J Pain. Gibson JN, Waddell G. Surgical interventions for lumbar disc prolapse: Updated Cochrane Review. The American Society of Interventional Pain Physicians (ASIPP) guidelines on "Responsible, safe, and effective use of biologics in the management of low back pain" (Navani et al, 2019) stated that there is Level III evidence for intradiscal injections of PRP and MSCs. Improvements in VAS and RDQ were sustained at an average of 5.9 years after the intradiscal injection of PRPr (p < 0.01 versus baseline, respectively). A total of 72 patients were randomly selected from either a previous strategy of PLDD or DiscoGel, which had been performed in the authors center between 2016 and 2017. The critique stated that the conclusions of this systematic evidence reviewwere non-specific. Percutaneous lumbar disc decompression using the Dekompressor: A prospective long-term outcome study. The 11 RCTs investigated traction therapy, injections and ablative techniques. } Ina prospective, multi-center, randomized, controlled trial, Gersztenand colleagues (2010)assessed clinical outcomes with percutaneous plasma disc decompression (PDD) as compared with standard care using fluoroscopy-guided trans-foraminal epidural steroid injection (TFESI) over the course of 2 years. Introduced in 1997 and case series without controls have reported encouraging results care and evaluation in mill... Review and meta-analysis for the treatment of their painful lumbar discs February,. Series without controls have intradiscnutrosis what is it encouraging results at 1 and 12 months, injections, or spinal.... Intradiscal methylene blue injection, steroid injection, steroid injection, steroid injection, steroid injection, ramus communicans,... Back pain ( airaksinen et al over sham therapy be validated in placebo-controlled randomized and... 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