Journal of Spine & NeurosurgeryISSN: 2325-9701

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none, J Spine Neurosurg Vol: 5 Issue: 2

Nucleoplasty with NuCore Injectable Nucleus Replacement for Herniated Lumbar Disc: A Multicenter Study with a Minimum Five-Year Follow-up

Berlemann U1, Schwarzenbach O1, Hoppe S1*, Diwan A2, Kitchel S3 and Coric D4
1Department of Orthopedic surgery, The Spine Center, Thun, Switzerland
2Department of Orthopedic surgery, University of New South Wales, St. George Hospital, Sydney, Australia
3Department of Orthopedic surgery, NeuroSpine Institute, Eugene OR, USA
4Department of Orthopedic surgery, Carolinas NeuroSurgery and Spine Associates, Charlotte NC, USA
Corresponding author : Sven Hoppe
Spine Center Thun, Bahnhofstrasse 3, Thun 3600 Switzerland
Received: January 23, 2016 Accepted: March 09, 2016 Published: March 16, 2016
Citation: Berlemann U, Schwarzenbach O, Hoppe S, Diwan A, Kitchel S, et al. (2016) Nucleoplasty with NuCore® Injectable Nucleus Replacement for Herniated Lumbar Disc: A Multicenter Study with a Minimum Five-Year Follow-up. J Spine Neurosurg 5:2. doi:10.4172/2325-9701.1000214


Study Design: Multicenter pooled analysis of prospective singlearm clinical trials. Objective: To assess the results of NuCore® Injectable Nucleus in long term. Summary of Background Data: Randomized controlled trials have shown discectomy to be effective in relieving pain due to first-time lumbar disk herniation. However, loss of intervertebral disk height and reherniation is not uncommon. NuCore® material is a synthetic polymer, implanted via injection into the nuclear void at discectomy. A previous mono-center study on 15 patients reported promising 2-year results. Methods: Thirty patients (age 18-60 years) at 4 centers were eligible. All patients underwent standard lumbar microdiscectomy followed by the injection of NuCore® Injectable Nucleus material. Outcomes included leg and back pain (Visual Analogue Scale), function (Oswestry Disability Index), quality-of-life assessed (SF- 36) and disc height (plain radiographs). An independent reviewer analyzed MRIs taken at different time points. Results: Twenty-five patients completed the five-year followup with an average follow-up period of 77 months. Overall four patients were revised due to reherniation of the nucleus, 2 of them within one week after index operation, two of them after >3 years postoperative. Clinical long-term improved in all categories: VAS leg pain decreased from 6.4(SD ± 2.4) pre- op to 1.1 (± 1.5) at latest follow-up. VAS back pain decreased from 4.2 (± 2.9) to 1.8 (± 2.0) and ODI from 42 (± 17) to 10 (± 8). Disc height loss was 15.9% at latest follow-up compared to pre-op. On MRI analysis no relevant reactions of the endplate nor new or worsening of pre-existing Modic changes were seen. Conclusion: Long-term data of patients undergoing nucleus augmentation with NuCore® Injectable Nucleus following lumbar microdiscectomy is favorable and comparable with the literature on outcomes after lumbar microdiscectomy. However, potential advantages such as a slow-down in the degenerative cascade of the disc have to be verified in randomized studies.

Keywords: microdiscectomy

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