Intradiscal biacuplasty sustains long-term superiority over conservative treatment for discogenic low-back pain


Patients treated with intradiscal biacuplasty (IDB) for discogenic back pain maintained benefits a year later. Those who transferred to IDB treatment mid-study reported similar gains, study authors reported 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, says Michael Gofeld, the principal investigator and senior author.

“The results were not only statistically significant, but—more importantly—clinically meaningful,” says Gofeld, a practicing chronic pain management specialist and anaesthesiologist 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.” 

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 two points on the visual analogue 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, Gofeld says. “Once both efficacy and effectiveness are established in such a rigorous research setting, the procedure should be approved by payers. It has no current procedural terminology (CPT) code, and the access for patients remains difficult.”