Percutaneous endoscopic discectomy and thermal annuloplasty for professional athletes.

Introduction: Percutaneous endoscopic discectomy (PED) for herniated nucleus pulposus has become increasingly popular since first reported by Yeung and Tsou. Additionally, radiofrequency thermal annuloplasty (TA) with PED (PED/TA) has been reported to be effective for discogenic low back pain. We used the PED/TA procedure to successfully treat four professional athletes with discogenic low back pain.

Methods: All patients were men; their age at operation was 35, 35, 34, and 28 years. Daily low back pain was provoked by discography in all four patients, who had been receiving conservative but ineffective treatment for over 1 year. Surgery was conducted with the patients under local anesthesia. A cannula was placed posterior to the disc and ventral to the posterior annulus fibrosus through a 7-mm skin incision. Degenerated nucleus pulposus at the site was removed percutaneously and the posterior annulus was modulated by bipolar radiofrequency TA.

Results: After surgery, low back pain was resolved in all cases. After effective post-surgical rehabilitation with a physical trainer or physical therapist, all patients returned to their original competitive level.

Conclusion: PED/TA is a minimally invasive and effective procedure for discogenic low back pain, especially in athletes.