Treatment of Multilevel Lumbar Disc Disease by SED and Thermal Annuloplasty

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A 57-year-old man, who was symptomatic with low back pain and bilateral sciatica due to lumbar spondylosis, underwent a diagnostic workup consisting of plain X-rays, an MRI, and discography. The working diagnoses were scoliosis and diffuse degenerative disc disease. After 2 years of physical therapy and nonsteroidal antiinflammatory drugs.

He still walked with a limp. Intraoperative discography with Isovue M 300 in combination with indigocarmine tissue staining confirmed painful annular tears at L2-3, L3-4, and L4-5, which were modulated by a bipolar radiofrequency probe and a Ho:YAG laser during Selective Endoscopic Discectomy™. Postoperatively, the patient required only mild analgesics and walked without a limp during two years of followup.