Suchergebnisse

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.

Objective A minimally invasive procedure for intervertebral disk resection using plasma beams has been developed. Conventional parameters for the plasma procedure such as voltage and tip speed mainly rely on the surgeon's personal experience, without adequate evidence from experiments. Our objective was to determine the optimal parameters for plasma disk resection.
Methods Rate of ablation was measured at different procedural tip speeds and voltages using porcine nucleus pulposi. The amount of heat formation during experimental conditions was also measured to evaluate the thermal safety of the plasma procedure.
Results The ablation rate increased at slower procedural speeds and higher voltages. However, for thermal safety, the optimal parameters for plasma procedures with minimal tissue damage were an electrical output of 280 volts root-mean-square (Vrms) and a procedural tip speed of 2.5 mm/s.
Conclusion Our findings provide useful information for an effective and safe plasma procedure for disk resection in a clinical setting.