Lower back pain with leg pain is often caused by impingement of the sciatic nerve, which in turn is often caused by lumbar disc herniation. Spinal discs are comprised of a gel-like nucleus and a tough exterior. If the nucleus material leaks through a cracked exterior, the disc is said to be herniated. The leaking material can press on and irritate nerves as they exit the spine.
For many, conservative treatment options such as physical therapy and inversion treatments will suffice to manage the pain of herniated discs, possibly facilitating reabsorption of lost disc fluids. But for some, surgery will be necessary.
The most common type of back surgery performed is spinal fusion, a complex and invasive procedure in which the vertebrae surrounding an injured disc or some other structural problem are set up to fuse together, creating a rigid spinal segment. While the surgery may alleviate the pain from a herniated disc, its expense and invasiveness, along with the risks associated with altering spinal mechanics, make it a last resort. Microdiscectomy is a less invasive, expensive and risky option for some.
Microdiscectomy entails the removal of herniated disc material, which resolves painful nerve irritation. This surgery, however, is not without its own unique complications. As tissue from the nucleus is removed, the disc is susceptible to re-herniation and/or loss of height, the latter of which alters spinal mechanics and can cause further pain. The available literature suggests that as many as a quarter of standard microdiscectomy recipients experience further disc problems after the procedure (a statistic that can be found in the link below).
In the interest of reducing these complications of microdiscectomy, the company Spine Wave developed NuCore, a biocompatible hydrogel that can be injected into spinal discs to act as nucleus material, maintaining disc height and preventing disc herniation after surgery. Research is currently being conducted to confirm results of preliminary research, which has been promising.
A pilot study with a 2-year follow-up looked at the maintenance of disc height as well as other measures, such as pain and disability, in 14 patients who received microdiscectomy followed by an injection of NuCore. Two years after the procedure, disc height was maintained an average of 92-3% across the discs’ length. Researchers also found that leg pain, back pain and disability scores plummeted after microdiscectomy with NuCore, maintaining steady results up to the 2-year follow-up.
See more on the study at www.ncbi.nlm.nih.gov.
Further studies with control groups and more participants will be needed to solidify the place of NuCore in microdiscectomy treatment. It’s important for patients to be aware of all options for back pain treatment, both those available now and those likely coming soon, to ensure they can make informed decisions.