Clinic and Outpatient Clinic for Orthopedics and Orthopedic Surgery, Greifswald University Medicine, Greifswald, Germany.
PLoS One. 2012;7(11):e50211. doi: 10.1371/journal.pone.0050211. Epub 2012 Nov 27.
We assessed volume following nucleoplasty disc decompression in lower lumbar spines from cadaveric pigs using 7.1Tesla magnetic resonance imaging (MRI).
To investigate coblation-induced volume reductions as a possible mechanism underlying nucleoplasty.
We assessed volume following nucleoplastic disc decompression in pig spines using 7.1-Tesla MRI. Volumetry was performed in lumbar discs of 21 postmortem pigs. A preoperative image data set was obtained, volume was determined, and either disc decompression or placebo therapy was performed in a randomized manner. Group 1 (nucleoplasty group) was treated according to the usual nucleoplasty protocol with coblation current applied to 6 channels for 10 seconds each in an application field of 360°; in group 2 (placebo group) the same procedure was performed but without coblation current. After the procedure, a second data set was generated and volumes calculated and matched with the preoperative measurements in a blinded manner. To analyze the effectiveness of nucleoplasty, volumes between treatment and placebo groups were compared.
The average preoperative nucleus volume was 0.994 ml (SD: 0.298 ml). In the nucleoplasty group (n = 21) volume was reduced by an average of 0.087 ml (SD: 0.110 ml) or 7.14%. In the placebo group (n = 21) volume was increased by an average of 0.075 ml (SD: 0.075 ml) or 8.94%. The average nucleoplasty-induced volume reduction was 0.162 ml (SD: 0.124 ml) or 16.08%. Volume reduction in lumbar discs was significant in favor of the nucleoplasty group (p<0.0001).
Our study demonstrates that nucleoplasty has a volume-reducing effect on the lumbar nucleus pulposus in an animal model. Furthermore, we show the volume reduction to be a coblation effect of nucleoplasty in porcine discs.
我们使用 7.1Tesla 磁共振成像（MRI）评估了尸体猪下腰椎间盘成形术后椎间盘的容积。
研究等离子消融诱导的容积减少是否是间盘成形术的潜在机制。
我们使用 7.1Tesla MRI 评估了猪脊柱间盘成形术后椎间盘的容积。对 21 例尸检猪的腰椎间盘进行了容积测量。获得术前图像数据集，确定体积，然后以随机方式进行椎间盘减压或安慰剂治疗。第 1 组（间盘成形术组）按常规间盘成形术方案治疗，在 360°的应用场中，每个通道应用 10 秒的等离子消融电流；第 2 组（安慰剂组）在同一程序中进行，但无等离子消融电流。术后生成第二组数据集，并以盲法计算和匹配术前测量的体积。为了分析间盘成形术的有效性，将治疗组和安慰剂组的体积进行了比较。
术前平均核体积为 0.994ml（标准差：0.298ml）。在间盘成形术组（n=21）中，体积平均减少 0.087ml（标准差：0.110ml）或 7.14%。在安慰剂组（n=21）中，体积平均增加 0.075ml（标准差：0.075ml）或 8.94%。间盘成形术引起的平均体积减少为 0.162ml（标准差：0.124ml）或 16.08%。腰椎间盘的容积减少在间盘成形术组中具有统计学意义（p<0.0001）。
本研究表明，间盘成形术在动物模型中对腰椎间盘有容积减少作用。此外，我们还证明了椎间盘成形术中的容积减少是等离子消融的效果。
