The Results of Cervical Nucleoplasty in Patients with Cervical Disc Disorder: A Retrospective Clinical Study of 22 Patients
2
조회
0
다운로드
5
인용
0
참고문헌
키워드
초록
Background:Nucleoplasty is a minimally invasive spinal surgery using a Coblation^Ⓡ technique that creates small voids within the disc. The purpose of this study was to evaluate the efficacy of cervical nucleoplasty in patients with cervical disc disorder. Methods:Between March 2008 and December 2009, 22 patients with cervical disc disorders were treated with cervical nucleoplasty after failed conservative treatment. All procedures were performed under local anesthesia, and fluoroscopic guidance and voids were created in the disc with the Perc^TM DC Spine Wand^TM. Clinical outcomes were evaluated by the Modified Macnab criteria and VAS score at preprocedure, postprocedure 1 month, and 6 months. Results:Six patients had one, eight patients had two and eight patients had three discs treated; a total of 46 procedures was performed. Mean VAS reduced from 9.3 at preprocedure to 3.7 at postprocedure 1 month and to 3.4 at postprocedure 6 months. There was no significant complication related to the procedure within the first month. Outcomes were good or excellent in 17/22 (77.3%) cases. Postprocedure magnetic resonance imaging was acquired in two patients after two months showing morphologic evidence of volume reduction of protruded disc material in one patient but not in the other. Conclusions:Percutaneous decompression with a nucleoplasty using a Coblation^Ⓡ technique in the treatment of cervical disc disorder is a safe, minimally-invasive and less uncomfortable procedure, with an excellent short-term clinical outcome.
Abstract
Background:Nucleoplasty is a minimally invasive spinal surgery using a Coblation^Ⓡ technique that creates small voids within the disc. The purpose of this study was to evaluate the efficacy of cervical nucleoplasty in patients with cervical disc disorder. Methods:Between March 2008 and December 2009, 22 patients with cervical disc disorders were treated with cervical nucleoplasty after failed conservative treatment. All procedures were performed under local anesthesia, and fluoroscopic guidance and voids were created in the disc with the Perc^TM DC Spine Wand^TM. Clinical outcomes were evaluated by the Modified Macnab criteria and VAS score at preprocedure, postprocedure 1 month, and 6 months. Results:Six patients had one, eight patients had two and eight patients had three discs treated; a total of 46 procedures was performed. Mean VAS reduced from 9.3 at preprocedure to 3.7 at postprocedure 1 month and to 3.4 at postprocedure 6 months. There was no significant complication related to the procedure within the first month. Outcomes were good or excellent in 17/22 (77.3%) cases. Postprocedure magnetic resonance imaging was acquired in two patients after two months showing morphologic evidence of volume reduction of protruded disc material in one patient but not in the other. Conclusions:Percutaneous decompression with a nucleoplasty using a Coblation^Ⓡ technique in the treatment of cervical disc disorder is a safe, minimally-invasive and less uncomfortable procedure, with an excellent short-term clinical outcome.
참고문헌 (13)
- Nardi PV, "Percutaneous cervical nucleoplasty using coblation technology. Clinical results in fifty consecutive cases", Acta Neurochir Suppl, 92, pp.73~78 (2005)
- Bonaldi G, "Plasma radio-frequency-based diskectomy for treatment of cervical herniated nucleus pulposus: feasibility, safety, and preliminary clinical results", AJNR Am J Neuroradiol, 27, pp.2104~2111 (2006)
- Sharps LS, "Percutaneous disc decompression using nucleoplasty", Pain Physician, 5, pp.121~126 (2002)
- Singh V, "Percutaneous disc decompression using coblation (nucleoplasty) in the treatment of chronic discogenic pain", Pain Physician, 5, pp.250~259 (2002)
- 노지영, "상지 방사통을 동반한 경추부 추간판 탈출증 환자에서의 수핵성형술 -증례 보고", Anesthesia and Pain Medicine, 4(3), pp.203~207 (2009), 대한마취과학회
- Chen YC, "Intradiscal pressure study of percutaneous disc decompression with nucleoplasty in human cadavers", Spine, 28, pp.661~665 (2003)
- Boswell MV, "Interventional techniques: evidence-based practice guidelines in the management of chronic spinal pain", Pain Physician, 10, pp.7~111 (2007)
- Birnbaum K, "Percutaneous cervical disc decompression", Surg Radiol Anat, 31, pp.379~387 (2009)
- Calisaneller T, "Six months post-operative clinical and 24 hour post-operative MRI examinations after nucleoplasty with radiofrequency energy", Acta Neurochir (Wien), 149, pp.495~500 (2007)
- Singh V, "Scientific basis for nucleoplasty", Tech Reg Anesth Pain Manag, 9, pp.13~24 (2005)
- Bhagia SM, "Side effects and complications after percutaneous disc decompression using coblation technology", Am J Phys Med Rehabil, 85, pp.6~13 (2006)
- Oh WS, "Psoas abscess and discitis after intradiscal nucleoplasty", Korean J Anesthesiol, 42, pp.844~849 (2002)
- Li J, "Percutaneous cervical nucleoplasty in the treatment of cervical disc herniation", Eur Spine J, 17, pp.1664~1669 (2008)