Percutaneous plasma laser disc coagulation and navigable ablation decompression in the treatment of cervical disc herniation: a single center experience
Percutaneous plasma laser disc coagulation and navigable ablation decompression in the treatment of cervical disc herniation: a single center experience
Background/aim: We aimed to compare the effectivity of percutaneous disc coagulation therapy (PDCT) and navigable ablationdecompression treatment (L-DISQ) in patients who were diagnosed with cervical disc herniation.Materials and methods: Visual analog scale (VAS) and Neck Pain Index (NPI) scores were recorded initially and at the 1st, 3rd, 6th, and12th months after the procedures. Patient Satisfaction Scale (PSS) scores were recorded 12 months after the procedures.Results: Mean VAS scores were 7.55 and 3.1 points in the PDCT group and 7.6 and 3.00 points in the L-DISQ group; mean NPI scoreswere 34.2 and 20.75 points in the PDCT group and and 34.1 and 20.4 points in the L-DISQ group initially and at the 12th month. Whencompared between months, there was a significant decrease in time-dependent VAS and NPI scores in both PDCT and L-DISQ groups(P = 0.001). Some complications included esophageal, vascular, and neural injuries; hoarseness; Horner syndrome; infections; duralpuncture; and muscle spasm. The only difference between groups was the rate of cervical spasm within 1 month after the procedure:75% in the PDCT group and 15% in the L-DISQ group.Conclusion: The diameter of the canal of the cervical vertebrae is narrower than of the lumbar and thoracic regions; therefore, thesmaller part of the disc may be sufficient to create clinical signs. The response to decompression therapies is faster in the case ofcervical percutaneous procedures that are performed correctly. Proper patient selection and practitioner’s experience are important inthe treatment success.
___
- 1. Radhakrishnan K, Litchy WJ, O’Fallon WM, Kurland LT.
Epidemiology of cervical radiculopathy: a population-based
study from Rochester, Minnesota, 1976 through 1990. Brain
1994; 117: 325-335.
- 2. Lu J, Ebraheim NA, Huntoon M, Haman SP. Cervical
intervertebral disc space narrowing and size of intervertebral
foramina. Clin Orthop Relat Res 2000; 370: 259-264.
- 3. Bilston LE, Thibault LE. The mechanical properties of the
human cervical spinal cord in vitro. Ann Biomed Eng 1996; 24:
67-74.
- 4. Derby R, Chen Y, Lee SH, Seo KS, Kim BJ. Non-surgical
interventional treatment of cervical and thoracic
radiculopathies. Pain Physician 2004; 7: 389-394.
- 5. Gebremariam L, Koes BW, Peul WC, Huisstede BM. Evaluation
of treatment effectiveness for the herniated cervical disc: a
systematic review. Spine 2012; 37: 109-118.
- 6. Nasser R, Yadla S, Maltenfort MG, Harrop JS, Anderson
DG, Vaccaro AR, Sharan AD, Ratliff JK. Complications in
spine surgery. J Neurosurg Spine 2010; 13: 144-157.
- 7. Schellhas KP, Smith MD, Gundry CR, Pollei SR. Cervical
discogenic pain: prospective correlation of magnetic resonance
imaging and discography in asymptomatic subjects and pain
sufferers. Spine 1996; 21: 300-312.
- 8. Bonaldi G, Baruzzi F, Facchinetti A, Fachinetti P, Lunghi S.
Plasma radio-frequency-based diskectomy for treatment of
cervical herniated nucleus pulposus: feasibility, safety, and
preliminary clinical results. AJNR Am J Neuroradiol. 2006; 27:
2104-2111.
- 9. Calisaneller T, Ozdemir O, Karadeli E, Altinors N. Six months
post-operative clinical and 24 hour post-operative MRI
examinations after nucleoplasty with radiofrequency energy.
Acta Neurochir 2007; 149: 495-500.
- 10. Cohen SP, Larkin T, Abdi S, Chang A, Stojanovic M. Risk factors
for failure and complications of intradiscal electrothermal
therapy: a pilot study. Spine 2003; 28: 1142-1147.
- 11. Lim JH, Lee HJ, Lee SH. Application of percutaneous cervical
nucleoplasty using the navigable disc decompression device in
patient of cervical herniated intervertebral disc: a case report.
Ann Rehabil Med 2013; 37: 730-734.
- 12. Kim SH, Lee SH, Kim NH, Kim MH, Park HJ, Jung YJ, Yoo HJ,
Meng WJ, Kim V. Clinical efficacy of selective focal ablation by
navigable percutaneous disc decompression device in patients
with cervical herniated nucleus pulposus. Ann Rehabil Med
2017; 41: 80-89.
- 13. Lee SH, Derby R, Sul DG, Hong JW, Kim GH, Kang S, Kim
NH, Yoo SH, Lee SJ, Hong YK et al. Efficacy of a new navigable
percutaneous disc decompression device (L’DISQ) in patients
with herniated nucleus pulposus related to radicular pain. Pain
Med 2011; 12: 370-376.
- 14. Lee SH, Ahn Y, Choi WC, Bhanot A, Shin SW. Immediate
pain improvement is a useful predictor of long-term favorable
outcome after percutaneous laser disc decompression for
cervical disc herniation. Photomed Laser Surg 2006; 24: 508-
513.
- 15. Park CW, Lee JY, Choi WJ, Chang SK. Percutaneous disc
coagulation therapy (PDCT) comparing with automated
percutaneous lumbar discectomy (APLD) in patients of
herniated lumbar disc disease: preliminary report. Korean J
Spine 2012; 9: 159-164.
- 16. Kim SH, Kim SC, Cho KH. Clinical outcomes of percutaneous
plasma disc coagulation therapy for lumbar herniated disc
diseases. J Korean Neurosurg Soc 2012; 51: 8-13.
- 17. Hong YK, Derby R, Wolfer LR, Kim SU, Kang BS, Kim
NH. An assessment of a new navigatable percutaneous disc
decompression device (L’DISQ) through histologic evaluation
and thermo-mapping in human cadaveric discs. Pain Medicine
2012; 13: 1000-1003
- 18. Arana E, Bonmati LM, Montijano R, Bautista D, Molla E, Costa
S. Relation between Northwick Park neck pain questionnaire
and cervical spine MR imaging findings. Eur Spine J 2006; 15:
1183-1188.
- 19. Nau WH, Diederich CJ. Evaluation of temperature distributions in cadaveric lumbar spine during nucleoplasty. Phys
Med Biol 2004; 49: 1583-1594.
- 20. Birnbaum K. Percutaneous cervical disc decompression. Surg
Radiol Anat 2009; 31: 379-387.
- 21. Hijikata S. Percutaneous nucleotomy: a new concept technique
and 12 years’ experience. Clin Orthop Relat Res 1989; 238:
9-23.
- 22. Karasek M, Bogduk N. Twelve-month follow-up of a controlled
trial of intradiscal thermal anuloplasty for back pain due to
internal disc disruption. Spine 2000; 25: 260-317.