Abstract Purpose:Intradiscal biacuplasty (IDB) has been proven to be effective for treating lumbar degenerative disc disease (DDD). However, there hasn’t been a reported prognostic factor for IDB. The present study meticulously evaluate the general and radiographic features which may serve as markers for predicting the therapeutic outcome of IDB.Methods:Forty-two patients suffering from chronic discogenic low back pain for more than 6 months and subsequently received lumbar cool radiofrequency IDB were enrolled. Twenty-three patients completed follow-up questionnaires at 1, 3, 6, and 12 months. The surgical outcomes were reported using visual analogue scale (VAS), Oswestry disability index (ODI), and the consumption of nonsteroidal anti-inflammatory drugs (NSAID). Furthermore, a univariate analysis was performed to identify prognostic factors associated with pain relief from age, gender, body mass index (BMI), and pre-operative lumbar magnetic resonance imaging reading. Results:Significant reductions were found in estimated VAS and ODI at the post-operative period at 1, 3, 6, and 12 months (P < 0.001). The NSAID dosage was significantly decreased at 3- and 6-month follow-up (P < 0.05). No procedure-related complications were detected. The prognosis of IDB was not related to disc height, Pfirrmann grading or Modic endplate change. However, disc extrusions were associated with promising outcomes (VAS improvement ≥ 50%) on pain relief (P < 0.05).Conclusion:IDB is a good choice for treating lumbar DDD. Patients with a disc extrusion may have a higher success rate of IDB, which can be used as an indicator in the physician’s decision-making process.