It is important to find an ideal indication for PLDD. Unsuccessful conservative treatment is a prerequisite of any spine surgery.
The aim of this retrospective, observational study was to investigate the frequency of an additional open surgery after PLDD in a more than ten-year retrospective.
Inclusion criteria were as follows: consecutive patients who underwent PLDD between January 2005 and December 2007.
For PLDD, the 17-gauge Dekompressor probe (Stryker, Kalamazoo, Michigan) was used.
MacNab's outcome criteria  (1 = Excellent, no pain, no restriction of activity; 2 = Good, occasional pain; 3 = Fair, improved but handicapped by intermittent pain; 4 = Poor, no improvement) were used to measure the success after PLDD. The evaluation of the necessity of an additional open lumbar spine surgery was the focus of this study.
Between January 2005 and December 2007, 86 patients were treated with PLDD. Because of spine surgery in their history, eleven patients were excluded.
The first follow-up examination one month after PLDD was mandatory for all patients.
Most reoperations (15 patients) had to be performed during the first year after PLDD (20.5% of all patients, 78.9% of all resurgeries).
This retrospective observational study investigated the number of patients with a subsequent open surgery after PLDD. Patients with back pain only and patients with radicular pain were included.
This means that the resurgery rate in the present study indicates additional surgery for a patient for whom conservative treatment was an alternative to PLDD. Recent studies found comparable resurgery rates for lumbar Nucleoplasty (18.7%, ) and for cervical Nucleoplasty (19.5 % ).
From the data of this study it remains unclear whether PLDD can achieve this objective.
With an early resurgery, it was suspected that the indication for PLDD was too generous.