Intradiscal Biacuplasty Sustains Long-term Superiority Over Conservative Treatment for Discogenic Low-Back Pain

Feb 18, 2016, 20:00 ET from American Academy of Pain Medicine

PALM SPRINGS, Calif., Feb. 18, 2016 /PRNewswire-USNewswire/ -- Patients treated with intradiscal biacuplasty (IDB) for discogenic back pain maintained benefits a year later, and those who crossed over to IDB treatment mid-study reported similar gains, study investigators reported. The results were presented today in a scientific poster at the 32nd Annual Meeting of the American Academy of Pain Medicine.

Contrary to the majority of chronic pain interventions, the minimally-invasive IDB demonstrated long-term benefit with no procedure-related complications, said Michael Gofeld, MD, the principal investigator and senior author.

"The results were not only statistically significant, but -- more importantly -- clinically meaningful," said Dr. Gofeld, a practicing chronic pain management specialist and anesthesiologist at St. Michael's Hospital and Women's College Hospital in Toronto, Canada, and an associate professor of Medicine at the University of Toronto. "Without addressing disc pathology, pain and function do not get better."  

Every year, up to one in five Americans suffers from low-back pain (LBP), and discogenic pain due to degeneration of the intervertebral discs is a chief cause. Sufferers are often forced to choose between conservative treatment, which includes medications such as nonsteroidal anti-inflammatory drugs and physical therapy, or more invasive fusion surgery, often with limited success or the risk of complications.

The investigators found that statistically and clinically significant improvements over baseline were sustained at 12 months on all measures, with pain reduction of more than 2 points on the visual analog scale and a decrease of 14 points on the Oswestry Disability Index.  The quality of life index also improved.

Now that clinical benefits have been established through this and previous research, barriers to insurance coverage must be addressed, Dr. Gofeld said.  "Once both efficacy and effectiveness are established in such a rigorous research setting, the procedure should be approved by payers. It has no CPT (insurance billing) code, and the access for patients remains difficult." 

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SOURCE American Academy of Pain Medicine