Abstract
Background
Low back pain (LBP) due to intervertebral disc (IVD) degeneration presents a major clinical challenge, impacting quality of life and imposing substantial economic burdens. Conventional treatments often provide symptomatic relief without addressing underlying disc degeneration. This study evaluates the efficacy of microdiscectomy combined with autologous microfragmented adipose tissue (MAT) injection in treating LBP associated with lumbar disc degeneration.
Methods
In this prospective case series, 32 adults with chronic LBP (> 6 months) with episode of sciatic nerve pain and MRI-confirmed Pfirrmann grade ≥ 3 IVD degeneration underwent microdiscectomy followed by autologous MAT injection using Lipocell technology. MAT was injected intradiscally, intra-facetally, or into the multifidus muscle based on individual MRI findings. Outcomes were assessed using the Visual Analog Scale (VAS), Oswestry Disability Index (ODI), Goutallier classification for muscle degeneration, and Pfirrmann classification for disc degeneration at baseline, 3 months, and 12 months post-treatment.
Results
Significant reductions in VAS (mean: 7.4 to 1.5 at 3 months, 0.3 at 12 months; p < 0.01) and ODI scores (mean: 52.9 to 24.9 at 3 months, 9.5 at 12 months; p < 0.01) were observed. Improvements were also noted in Goutallier classification, indicating reduced fatty infiltration in multifidus muscle, and in Pfirrmann grades, suggesting enhanced disc structure and reduced degeneration.
Conclusions
Combining microdiscectomy with autologous MAT injection offers effective pain relief and functional improvement in patients with LBP due to IVD degeneration, addressing both symptoms and underlying pathology. These findings support further investigation into this combined therapeutic approach.