Clinical Study Of Coblation Nucleoplasty And Bipolar Radiofrequency Thermocoagulation In The Treatment Of Interdiscogenic Low Back Pain

Objective:To compare the effect difference between Coblation nucleoplasty and Bipolar radiofrequency thermocoagulation in the treatment of interdiscogenic low back pain.Method:A total of 140 patients with discogenic low back pain who were hospitalized in the Spinal Surgery Department of Dalian Third People’s Hospital from January 2018 to May 2022 were divided into 3 groups according to the treatment method: The observation group received Coblation nucleoplasty(group A: 60 cases),the control group received bipolar radiofrequency thermocoagulation(group B: 45 cases),and the control group received non-surgical treatment(group C: 35 cases).The modified Macnab evaluation,ODI index and VAS score were used to analyze the data of the three groups before surgery,1 week,1 month,3 months and 6 months after surgery,so as to obtain the difference of the efficacy of the two treatments.Result:1.VAS score: The VAS score of group A was 6.93±0.80 before surgery,3.08±0.85 1 week after surgery,2.47±0.53 1 month after surgery,1.55±0.50 3 months after surgery,and 1.38±0.49 6 months after surgery.The VAS score of group B before surgery was 6.93±0.89,5.00±0.74 one week after surgery,3.91±0.79 one month after surgery,3.09±0.82 three months after surgery,and 2.53±0.51 six months after surgery.The VAS score of group C was 7.17±0.82 before surgery,6.54±0.51 one week after surgery,5.60±0.50 one month after surgery,4.34±0.48 three months after surgery,and 4.09±0.78 six months after surgery.According to the analysis of variance before and after the operation,there was no significant difference before the operation(P > 0.05),but there was significant difference at each time point after the operation(P < 0.05).2.Oswestry Disability Index(ODI): The ODI index of group A was 52.20±6.71 before surgery,28.20±4.08 one week after surgery,16.43±2.42 one month after surgery,13.42±1.66 three months after surgery,and 10.38±1.42 six months after surgery.The ODI index of group B was 52.16±6.42 before surgery,33.71±4.93 one week after surgery,30.47±3.54 one month after surgery,25.20±2.94 three months after surgery,and 16.78±1.38 six months after surgery.The ODI index of group C was 51.86±5.80 before surgery,38.23±1.37 1 week after surgery,40.26±1.44 1 month after surgery,34.29±1.02 3 months after surgery,and 29.80±1.45 6 months after surgery.According to the analysis of variance before and after the operation,there was no significant difference before the operation(P > 0.05),but there was significant difference at each time point after the operation(P < 0.05).3.Improved Macnab assessment standards: One week later,the good and good rates of group A,group B and group C were 48.3%,2.2% and 0%,respectively.One month later,the good and good rates of group A,group B and group C were 90.0%,37.8% and 0%,respectively.After 3 months,the good and good rates of group A,group B and group C were 78.4%,64.5% and 68.6%,respectively.After 6 months,the good and good rates of group A,group B and group C were 86.6%,84.5% and 40%,respectively.Chisquare test showed that the rate of good and good among the three groups was P < 0.05 at each time point after surgery,and the difference was statistically significant.Conclusion:Coblation nucleoplasty and bipolar radiofrequency thermocoagulation can both achieve satisfactory results in the treatment of discogenic low back pain,and coblation nucleoplasty is more effective.