Download PDF
J Neurol Surg A Cent Eur Neurosurg 2018; 79(03): 231-238
DOI: 10.1055/s-0037-1615273
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Feasibility of Navigable Percutaneous Disk Decompressor (L'DISQ-C) for Cervical Disk Herniation

Youngki Hong
1   Department of Sports Medicine, Cheongju University, Cheongju, the Republic of Korea
,
Seunghan Yoo
2   Department of Physical Medicine and Rehabilitation, Korea University Medical Center, Seoul, the Republic of Korea
,
Nack Hwan Kim
2   Department of Physical Medicine and Rehabilitation, Korea University Medical Center, Seoul, the Republic of Korea
,
Yushin Kim
3   Department of Mechanical Engineering, Korea Advanced Institute of Science and Technology, Daejeon, the Republic of Korea
,
Sangho Sohn
4   Department of Preventive Medicine, Korea University College of Medicine and School of Medicine, Seoul, Korea (the Republic of)
,
Sung-Young Yoon
5   Plasma Technology Research Center, National Fusion Research Institute, Gunsan, the Republic of Korea
,
Sangheon Lee
2   Department of Physical Medicine and Rehabilitation, Korea University Medical Center, Seoul, the Republic of Korea
› Author Affiliations
Further Information

Publication History

02 July 2017

23 October 2017

Publication Date:
18 January 2018 (online)

    Permissions and Reprints

Abstract

Objective To assess the procedural efficacy and safety of a Navigable Percutaneous Disk Decompressor (L'DISQ-C) for cervical disk herniation.

Methods We performed intradiskal decompression on cervical spine specimens from five human cadavers using the L'DISQ-C under C-arm fluoroscopic guidance. We evaluated our success for positioning the navigable wand tip into the target region and recorded temperature variation at various distances from the wand tip in the cervical nucleus pulposus. The histologic effect of plasma decompression was examined microscopically using harvested tissues adjacent to the procedure site.

Results We successfully navigated the tip of the L'DISQ-C into the target region of the posterior cervical disks on the first insertion attempt in all C3–C4 to C6–C7 disks and in 50% of the C2–C3 and C7–T1 disks. The average temperature elevations within the nucleus pulposus ranged from 4.14 ± 0.08°C to 12.17 ± 0.76°C at various distances from the wand tip with or without saline infusion. A histologic examination showed only minor denaturation at the marginal border of the procedure tract.

Conclusion We effectively navigated the L'DISQ-C wand tip into the posterior target region of six cadaveric cervical disks and performed percutaneous resection of the target disk tissues without significant thermal or structural damage to adjacent tissues.

Keywords

herniated disk - percutaneous decompression - plasma energy - spinal interventional treatment - navigable procedure
 

  • References

  • 1 Azzazi A, AlMekawi S, Zein M. Lumbar disc nucleoplasty using coblation technology: clinical outcome. J Neurointerv Surg 2011; 3 (03) 288-292
    CrossrefPubMedGoogle Scholar
  • 2 Couto JM, Castilho EA, Menezes PR. Chemonucleolysis in lumbar disc herniation: a meta-analysis. Clinics (Sao Paulo) 2007; 62 (02) 175-180
    CrossrefPubMedGoogle Scholar
  • 3 Gobin P, Theron J, Courtheoux F, Huet H, Chos D, Loyau G. Percutaneous automated lumbar nucleotomy. J Neuroradiol 1989; 16 (03) 203-213
    PubMedGoogle Scholar
  • 4 Li J, Yan DL, Zhang ZH. Percutaneous cervical nucleoplasty in the treatment of cervical disc herniation. Eur Spine J 2008; 17 (12) 1664-1669
    CrossrefPubMedGoogle Scholar
  • 5 Gangi A, Tsoumakidou G, Buy X, Cabral JF, Garnon J. Percutaneous techniques for cervical pain of discal origin. Semin Musculoskelet Radiol 2011; 15 (02) 172-180
    Article in Thieme ConnectPubMedGoogle Scholar
  • 6 Lee SH, Derby R, Sul Dg. , 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 (03) 370-376
    CrossrefPubMedGoogle Scholar
  • 7 Hong YK, Derby R, Wolfer LR. , et al. An assessment of a new navigable percutaneous disc decompression device (L'DISQ) through histologic evaluation and thermo-mapping in human cadaveric discs. Pain Med 2012; 13 (08) 1000-1003
    CrossrefPubMedGoogle Scholar
  • 8 Society ISI, Bogduk N. ISIS Practice Guidelines for Spinal Diagnostic and Treatment Procedures. 2nd ed. Hinsdale, IL: International Spine Intervention Society; 2014
    Google Scholar
  • 9 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 (03) 300-311 , discussion 311–312
    CrossrefPubMedGoogle Scholar
  • 10 Birnbaum K. Percutaneous cervical disc decompression. Surg Radiol Anat 2009; 31 (05) 379-387
    CrossrefPubMedGoogle Scholar
  • 11 Chen Y, Derby R, Lee SH. Percutaneous disc decompression in the management of chronic low back pain. Orthop Clin North Am 2004; 35 (01) 17-23
    CrossrefPubMedGoogle Scholar
  • 12 Jaikumar S, Kim DH, Kam AC. History of minimally invasive spine surgery. Neurosurgery 2002; 51 (5, Suppl): S1-S14
    CrossrefPubMedGoogle Scholar
  • 13 Chen YC, Lee SH, Chen D. Intradiscal pressure study of percutaneous disc decompression with nucleoplasty in human cadavers. Spine 2003; 28 (07) 661-665
    CrossrefPubMedGoogle Scholar
  • 14 Sharps LS, Isaac Z. Percutaneous disc decompression using nucleoplasty. Pain Physician 2002; 5 (02) 121-126
    PubMedGoogle Scholar
  • 15 Wall MS, Deng XH, Torzilli PA, Doty SB, O'Brien SJ, Warren RF. Thermal modification of collagen. J Shoulder Elbow Surg 1999; 8 (04) 339-344
    CrossrefPubMedGoogle Scholar
  • 16 Cloward RB. The anterior approach for removal of ruptured cervical disks. J Neurosurg 1958; 15 (06) 602-617
    CrossrefPubMedGoogle Scholar