{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T04:50:19Z","timestamp":1782190219463,"version":"3.54.5"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T00:00:00Z","timestamp":1782172800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Discogenic pain and contained lumbar disk herniation are important causes of chronic low back pain. Current intradiscal minimally invasive techniques have long-term efficacy limitations. Disk percutaneous ablation and extraction (DPAE) lacks systematical long-term outcomes evaluation. This study compared mid-to-long-term clinical outcomes of DPAE and standard Disc-FX in such patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This single-center retrospective cohort study included 198 patients: 110 underwent DPAE, 88 received Disc-FX. Primary outcome was the change in low back pain visual analog scale (VAS) score at 24\u202fmonths. Secondary outcomes included Oswestry Disability Index (ODI), Patient Global Impression of Change (PGIC), achievement of the minimal clinically important difference (MCID), composite treatment success, and reintervention rate. The safety endpoint was perioperative\/follow-up complications. Propensity score matching controlled confounding; statistical analyses included analysis of covariance, linear mixed-effects models, logistic regression, and Cox models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At 24\u202fmonths, DPAE group had a mean VAS reduction of 5.29\u202f\u00b1\u202f2.06 vs. 4.17\u202f\u00b1\u202f2.24 in Disc-FX group (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), with an additional 1.05-point reduction (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u202f=\u202f\u22121.05, 95%CI \u22121.57 to \u22120.53;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). The DPAE group demonstrated better improvement in ODI, higher PGIC marked improvement, higher VAS\/ODI MCID rates, and higher composite success rate (70.0% vs. 51.1%, all\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05). Reintervention rate was 7.3% (DPAE) vs. 14.8% (Disc-FX); DPAE reduced reintervention risk (HR\u202f=\u202f0.46, 95%CI 0.20 to 0.99;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.047). Complication rates (6.4% vs. 9.1%) had no statistically significant difference.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Disk percutaneous ablation and extraction may offer a more durable minimally invasive treatment option. Future multicenter prospective studies are warranted to further validate its long-term efficacy and define its optimal indications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1839430","type":"journal-article","created":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T04:34:06Z","timestamp":1782189246000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Real-world 24-month pain outcomes of disk percutaneous ablation and extraction versus Disc-FX nucleoplasty for lumbar discogenic pain and contained lumbar disk herniation: a single-center retrospective cohort study"],"prefix":"10.3389","volume":"17","author":[{"given":"Xiaohui","family":"Yang","sequence":"first","affiliation":[{"name":"Department of Pain Management, Aerospace Center Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaxiang","family":"Ni","sequence":"additional","affiliation":[{"name":"Department of Pain Management, Capital Medical University Xuanwu Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,23]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"5915","DOI":"10.3390\/jcm13195915","article-title":"Discogenic low Back pain: anatomic and pathophysiologic characterization, clinical evaluation, biomarkers, AI, and treatment options","volume":"13","author":"De Simone","year":"2024","journal-title":"J Clin Med"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"e70062","DOI":"10.1111\/papr.70062","article-title":"14. Discogenic low Back pain","volume":"25","author":"van Os","year":"2025","journal-title":"Pain Pract"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"104693","DOI":"10.1016\/j.jpain.2024.104693","article-title":"Human molecular mechanisms of discogenic low back pain: a scoping review","volume":"27","author":"Chiu","year":"2025","journal-title":"J Pain"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1016\/j.rcl.2023.10.003","article-title":"Imaging of Discogenic and Vertebrogenic pain","volume":"62","author":"Abel","year":"2024","journal-title":"Radiol Clin North Am"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"657","DOI":"10.4103\/ajns.AJNS_119_17","article-title":"Current concepts in Intradiscal percutaneous minimally invasive procedures for chronic low Back pain","volume":"14","author":"Gelalis","year":"2019","journal-title":"Asian J Neurosurg"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"5","DOI":"10.2217\/pmt-2023-0107","article-title":"Mesenchymal stem cells and thermal annular procedures for discogenic pain: a systematic review with pooled analysis","volume":"14","author":"DesRochers","year":"2024","journal-title":"Pain Manag"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"362","DOI":"10.1111\/pme.12023","article-title":"A randomized, placebo-controlled trial of transdiscal radiofrequency, biacuplasty for treatment of discogenic lower back pain","volume":"14","author":"Kapural","year":"2013","journal-title":"Pain Med"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1065","DOI":"10.1097\/BRS.0000000000001412","article-title":"A prospective, randomized, multicenter, open-label clinical trial comparing Intradiscal Biacuplasty to conventional medical management for Discogenic lumbar back pain","volume":"41","author":"Desai","year":"2016","journal-title":"Spine"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1131","DOI":"10.3233\/BMR-240024","article-title":"Effectiveness of intradiscal ozone injections for treating pain following herniated lumbar disc: a systematic review and meta-analysis","volume":"37","author":"Chang","year":"2024","journal-title":"J Back Musculoskelet Rehabil"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"362","DOI":"10.22603\/ssrr.2023-0294","article-title":"Indication and limitation of Intradiscal Condoliase injection for patients with lumbar disc herniation: literature review and Meta-analysis","volume":"8","author":"Nakajima","year":"2024","journal-title":"Spine Surg Related Res"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"699","DOI":"10.1186\/s13018-025-06025-2","article-title":"Application and mechanism of percutaneous puncture disc platelet-rich plasma injection for lumbar disc herniation: a systematic review and meta-analysis","volume":"20","author":"Xie","year":"2025","journal-title":"J Orthop Surg Res"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1291","DOI":"10.3390\/medicina59071291","article-title":"An effectiveness evaluation of nucleo-annuloplasty for lumbar discogenic lesions using Disc-FX: a scoping review","volume":"59","author":"Lin","year":"2023","journal-title":"Medicina"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"365","DOI":"10.1177\/2192568217726525","article-title":"Annulo-Nucleoplasty using disc-Fx in the Management of Degenerative Lumbar Disc Pathology: how long can the effect last?","volume":"8","author":"Kumar","year":"2018","journal-title":"Global Spine J"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"6378","DOI":"10.3390\/jcm14186378","article-title":"Long-term clinical efficacy of the disc-FX procedure in contained disc herniation: a 7-year follow-up from a single-center cohort study","volume":"14","author":"Rybaczek","year":"2025","journal-title":"J Clin Med"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1186\/s40981-026-00846-8","article-title":"Evaluation of disc-FX versus L'DISQ for percutaneous disc decompression: pilot comparative study using the minimal clinically important difference","volume":"12","author":"Takaoka","year":"2026","journal-title":"JA Clin Report"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"398","DOI":"10.1016\/j.wneu.2022.07.066","article-title":"Contraindications and complications of full endoscopic lumbar decompression for lumbar spinal stenosis: a systematic review","volume":"168","author":"Ju","year":"2022","journal-title":"World Neurosurg"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"841","DOI":"10.35975\/apic.v29i8.3005","article-title":"Efficacy and safety of intradiscal bipolar radiofrequency annuloplasty in patients diagnosed with lumbar discogenic pain","volume":"29","author":"Chen","year":"2025","journal-title":"Anaesth Pain Intensive Care"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"e39739","DOI":"10.1097\/MD.0000000000039739","article-title":"Clinical observation of low temperature plasma ablation combined with collagenase injection in lumbar disc herniation","volume":"103","author":"Zhang","year":"2024","journal-title":"Medicine"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"1508","DOI":"10.1097\/BRS.0000000000004730","article-title":"Percutaneous Transforaminal endoscopic discectomy learning curve: a CuSum analysis","volume":"48","author":"Maayan","year":"2023","journal-title":"Spine"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"561","DOI":"10.1055\/s-0043-1775760","article-title":"Transforaminal endoscopic lumbar Diskectomy versus open Microdiskectomy for symptomatic lumbar disk herniation: a comparative cohort study on costs and long-term outcomes","volume":"85","author":"Saghebdoust","year":"2024","journal-title":"J Neurol Surg"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"2910","DOI":"10.1007\/s00586-023-07786-2","article-title":"Awake transforaminal endoscopic lumbar discectomy in an ambulatory surgery center: early clinical outcomes and complications of 100 patients","volume":"32","author":"Alexander","year":"2023","journal-title":"Eur Spine J"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"159","DOI":"10.21037\/jss-22-54","article-title":"Transforaminal endoscopic lumbar discectomy: learning curve of a single surgeon","volume":"9","author":"Fleiderman","year":"2023","journal-title":"J Spine Surgery"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"851","DOI":"10.1111\/os.14013","article-title":"Correlation between disc imaging observations and clinical efficacy after percutaneous endoscopic lumbar discectomy: a 1-year follow-up study","volume":"16","author":"Li","year":"2024","journal-title":"Orthop Surg"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"4301","DOI":"10.2147\/JPR.S475650","article-title":"Development of Modic changes after percutaneous endoscopic Transforaminal lumbar discectomy: from risk analysis to prediction modeling","volume":"17","author":"Li","year":"2024","journal-title":"J Pain Res"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"1188517","DOI":"10.3389\/fsurg.2023.1188517","article-title":"Nomogram for predicting the unfavourable outcomes of percutaneous endoscopic transforaminal discectomy for lumbar disc herniation: a retrospective study","volume":"10","author":"Jiang","year":"2023","journal-title":"Front Surg"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2026.1839430\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T04:34:22Z","timestamp":1782189262000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2026.1839430\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,23]]},"references-count":25,"alternative-id":["10.3389\/fneur.2026.1839430"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2026.1839430","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,23]]},"article-number":"1839430"}}