Clinical value of provocative discography combined with fully visible percutaneous endoscopic surgery in the diagnosis and treatment of discogenic low back pain

Objective To explore the diagnostic methods and analyse the clinical effect of provocative discography combined with fully visible percutaneous endoscopic surgery of discogenic low back pain (DLBP). Methods The clinical data of 29 patients diagnosed with DLBP by provocative discography admitted to the department of orthopedics of Jiangsu Province Hospital on Integration of Chinese and Western Medicine from July 2015 to June 2018 were retrospectively analyzed. The patients underwent a fully visible percutaneous endoscopic procedure(disectomy and bipolar annuloplasty). The Visual Analog Scale (VAS) score and Oswestry Disability Index (ODI) score (preoperative, postoperative 1 day, 3 months, 6 months) were evaluated. The clinical global outcomes were assessed on the basis of modified MacNab criteria. Results All patients were successfully performed the operation. VAS significantly declined from preoperative (6.62±1.01) to postoperative 1 day (1.53±0.43), 3 months (1.06±0.61) and 6 months (0.71±0.37) (F=132.13, P<0.05). ODI decreased from preoperative (51.11±10.15) to 1 day (14.12±1.43), 3 months(12.98±2.01) and 6 months (10.33±1.46) (F=293.35, P<0.05). At the last follow-up, 22 cases of the MacNab results were excellent, 5 cases were good, 2 cases were fair, and none was bad, and the excellent-to-good rate was 93.10%(27/29). Conclusion With fewer complications and a lower risk, provocative discography combined with fully visible percutaneous endoscopic surgery is safe and efficacious in the treatment of DLBP. Key words: Discogenic low back pain; Discography; Endoscopy