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New Back Pain MIS treatment method-research study results 2025

-Comparison of a Minimally Invasive Steerable Disc Radiofrequency(RF) Decompression Device(Yesdisc) for Prolapsed Lumbar Discs versus Central Disc Nucleoplasty RF Coblation

Author: Dr Rajendra Tiruchelvarayan, Gleneagles Medical Centre , Singapore 


Background

Back pain due to prolapsed intervertebral discs(PID) is common. When medical treatment is ineffective, radiofrequency(RF) disc ablation techniques can be used. Previous RF Co-blation(RFA) procedures only decompress the disc centrally.

Objectives

We present our experience with a newer Minimally Invasive Steerable Disc Decompression Device(Yesdisc) for herniated discs(Central/Paramedian). This can be navigated to the disc herniation site, achieving a targeted decompression relieving both back pain/sciatica. We compare this with older Disc RF techniques(Arthrocare Wand).

Methodology

The study was a Single Spine Surgeon Prospective Study. Eighty seven(87) patients were involved. From November 2015 to September 2017, the author performed only central nucleoplasty decompression procedures. From October 2017 to 2022, the author performed steerable L-Disq RF procedures. From 2022 to date, the author uses the newer Yesdisc steerable RF Coblation catheter. This new catheter allows for better steerability and accuracy. The procedures were performed in the day surgery operating theatre with fluoroscopic c-arm guidance.

Results

There were a total of 87 patients. Thirty three(33) patient underwent the Yesdisc procedure, thirty four(34) patients underwent the L-Disq procedure, compared to twenty(20) patients who underwent the central disc nucleoplasty. For the Yesdisc group, a total of 40 levels were treated, as some patient had multiple PID levels. The best improvement in VAS was seen in the Yesdisc group(85% had statistically significant improvement at 3 months follow-up). For the L-disq group, results were also good at 75%. Only 1 patient in the Yesdisc group needed lumbar microdiscectomy surgery, compared to 4 patients in the L-disq group. In all 3 groups, there were no complications such as discitis/neural damage.

For the Central Disc Nucleoplasty group, there were 20 patients. 14 patients(70%) had significant improvement in pain. The average VAS at 3 months decreased from 7.5 to 1.5. One patient required lumbar microdiscectomy. There was 1 case of transient leg numbness, which improved.

Conclusion

The Yesdisc Coblation RF procedure had the best results for treating small to medium sized lumbar disc herniations(85% success rate, at 3 months). This is better than the 2 other groups. It is an effective MIS treatment for PID with a low complication rate.

MIS Disc RF Decompression
MIS Disc RF Decompression

-Research study presented at Asia Pacific Spine Society Meeting(APSS)-MSS Spine Meeting 2025

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