Percutaneous Lumbar Thermal Annular Procedure

Percutaneous lumbar thermal annular procedures are minimally invasive spine treatments used to manage chronic discogenic low back pain caused by internal annular disruption. Internal annular disruption occurs when small tears in the outer layer of the intervertebral disc (annulus fibrosus) allow nerve fibers to grow inward, generating persistent pain.

Internal annular disruption accounts for approximately 25% of chronic low back pain cases. Diagnosis is typically confirmed with discography.

What Are Percutaneous Lumbar Thermal Annular Procedures?

Percutaneous lumbar thermal annular procedures use controlled heat to treat damaged disc tissue. The goal is to reduce pain by modifying the annulus and targeting nerve fibers within the disc.

These procedures are minimally invasive and performed under imaging guidance.

Thermal energy can be delivered through:

  1. Radiofrequency energy
  2. Thermal cautery
  3. Laser therapy
  4. Electrocautery

Conditions Treated

Percutaneous lumbar thermal annular procedures are used to treat:

  1. Discogenic low back pain
  2. Internal annular disruption
  3. Contained disc herniation
  4. Chronic axial low back pain without significant radiculopathy

These procedures are considered when conservative treatments and epidural injections fail to provide adequate relief.

Candidate Criteria

You may be a candidate if you meet the following criteria:

  1. Discogenic pain confirmed by discography
  2. Failure to improve after at least six weeks of conservative treatment
  3. Age younger than 55 years
  4. No significant facet joint disease
  5. No major psychological contraindications
  6. Posterior annular defect
  7. Axial low back pain greater than leg pain for 3–6 months
  8. Contained disc herniation
  9. Preserved disc height greater than 50%

Careful patient selection is essential for optimal outcomes.

Table of Contents

How the Procedure Is Performed

The procedure is performed in an outpatient setting under fluoroscopic (live X-ray) guidance.

It typically includes:

  1. Administration of local anesthesia and sedation as needed
  2. Insertion of a needle or catheter into the affected disc
  3. Precise placement of a thermal device in the annulus
  4. Controlled application of heat to the damaged disc tissue

The procedure generally takes less than one hour.

Benefits of Percutaneous Lumbar Thermal Annular Procedures

  • Minimally invasive alternative to spinal fusion
  • Targeted treatment of discogenic pain
  • Preservation of spinal anatomy
  • Reduced recovery time compared to open surgery
  • Potential improvement in function and mobility

Begin your journey to recovery.

Reach out to our specialists to schedule an initial consultation. We’ll carefully review your symptoms and match you with the right expert for your specific condition.

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