Department of Anesthesiology and Pain Medicine, Seoul National University Boramae Hospital, Seoul, Korea.
Korean J Pain. 2011 Mar;24(1):36-43. doi: 10.3344/kjp.2011.24.1.36. Epub 2011 Feb 25.
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.
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™ DC Spine Wand™. Clinical outcomes were evaluated by the Modified Macnab criteria and VAS score at preprocedure, postprocedure 1 month, and 6 months.
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.
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.
经皮髓核成形术是一种采用等离子射频技术的微创脊柱手术,该技术可在椎间盘内产生微小的空穴。本研究旨在评估颈椎间盘疾病患者接受颈椎髓核成形术的疗效。
2008 年 3 月至 2009 年 12 月,22 例颈椎间盘疾病患者在保守治疗失败后接受颈椎髓核成形术治疗。所有手术均在局部麻醉下进行,采用 Perc™ DC Spine Wand™ 在椎间盘内创建空洞。采用改良 Macnab 标准和 VAS 评分评估术前、术后 1 个月和 6 个月的临床疗效。
6 例患者 1 个椎间盘、8 例患者 2 个椎间盘和 8 例患者 3 个椎间盘接受治疗,共进行了 46 次手术。VAS 评分从术前的 9.3 分降至术后 1 个月的 3.7 分,再降至术后 6 个月的 3.4 分。术后 1 个月内无与手术相关的严重并发症。22 例患者中,17 例(77.3%)疗效良好或优秀。术后 2 个月对 2 例患者进行了磁共振成像检查,其中 1 例患者显示突出椎间盘物质的形态学体积缩小,但另 1 例患者未显示。
采用等离子射频技术经皮减压治疗颈椎间盘疾病是一种安全、微创、舒适性好的手术,短期临床疗效良好。