Long-Term Clinical Efficacy of the Disc-FX Procedure in Contained Disc Herniation: A 7-Year Follow-Up from a Single-Center Cohort Study

<b>Background:</b> Contained lumbar disc herniation is a prevalent cause of chronic low back pain and functional impairment. The Disc-FX system, a minimally invasive, percutaneous technique integrating nucleotomy, nucleus ablation, and annuloplasty, offers a multimodal approach to managing early degenerative disc disease. Despite promising short-term outcomes, evidence regarding long-term effectiveness remains limited. <b>Methods:</b> This single-center cohort study evaluated 197 patients (median age: 48 years; 56.85% female) who underwent the Disc-FX procedure between 2017 and 2024. Patients were followed for up to 84 months. Pain and disability were assessed using a Visual Analog Scale (VAS) and the Oswestry Disability Index (ODI), respectively, while satisfaction was measured by the MacNab criteria. Multivariable models, including cumulative link models and linear mixed-effects models, were used to identify predictors of outcomes. <b>Results:</b> The Disc-FX procedure resulted in significant and sustained improvements in pain and function. Mean VAS scores decreased from 7.79 preoperatively to 4.31 at 12 months and remained below baseline at 84 months (5.05). ODI scores improved from 15.43 preoperatively to 9.62 at 36 months, rising slightly to 12.75 at 84 months. Good or excellent outcomes were reported in 66.9% of patients according to MacNab criteria. Male sex (OR = 0.41), longer symptom duration (OR = 0.85), and presence of radicular symptoms (OR = 0.39) were significantly associated with less favorable outcomes. Reoperation occurred in 26.4% of cases, predominantly within the first year and most frequently at L4/L5. Complications were rare (3.08%). <b>Conclusions:</b> This study provides robust evidence supporting the long-term clinical efficacy of the Disc-FX procedure in selected patients with contained lumbar disc herniation. While overall outcomes are favorable, optimal results depend on early intervention and careful patient selection, particularly in relation to symptom chronicity and the presence of radicular signs.