Identification of intervertebral disc regeneration with magnetic resonance imaging after a long-term follow-up in patients treated with percutaneous diode laser nucleoplasty: a retrospective clinical and radiological analysis of 14 patients

Arslan, Erhan; Demirci, İrşadi; Kılınçaslan, Mehmet Oğuz; Hacıfazlıoğlu, Çiğdem; Demir, Tuğcan; Demirkale, İsmail

doi:10.1007/s00586-014-3194-1

Cited by 6 publications

(1 citation statement)

References 26 publications

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“…It was incidentally noted that all three patients showed an increased signal intensity on sagittal T2 images when compared to pre-procedure MRI, suggesting rehydration of the disc after the Disc-FX procedure consistent with other reports in the literature. 25 …”

Section: Discussionmentioning

confidence: 99%

Annulo-nucleoplasty using Disc-FX in the management of lumbar disc pathology: Early results

Kumar

et al. 2014

Int J Spine Surg

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BackgroundBack pain due to Lumbar Disc Disease is a major clinical problem. The treatment options range from physiotherapy to fusion surgery. A number of minimally invasive procedures have also been developed in the recent past for its management. Disc-FX is a new minimally invasive technique that combines percutaneous discectomy, nuclear ablation and annular modification. Literature on its role in the management of lumbar disc pathology is scarce.MethodsWe included 24 consecutive patients who underwent the Disc-FX for back pain due to lumbar disc pathology non-responsive to non-operative treatment for a period of at least 6 months. Based on Magnetic Resonance Imaging (MRI) these patients fell into 2 groups – those with degenerative disc disease (DDD) (n = 12) and those with a contained lumbar disc herniation (CLDH)(n = 12). They were evaluated using the Visual analogue scale (VAS), Oswestry Disability Index (ODI) and Short Form-36 (SF-36) scores preoperatively and postoperatively.ResultsThe mean age was 37.9 years (21-53 years). There were 17 males and 7 females. One patient in each subgroup was excluded from the final evaluation. Significant improvement was seen in all outcome measures. The overall rate of reintervention for persistent symptoms was 18.18% (4/22); in the CLDH subgroup, it was 36.36% (4/11).Conclusions and level of evidenceEarly results after the Disc-FX procedure suggest that it s a reasonable treatment option for patients with back pain due to lumbar disc disease, especially for those with DDD who fail conservative treatment. It could be an alternative to procedures like fusion or disc replacement.This study presents Level IV evidence.Clinical relevanceWe feel that our study establishes Disc-FX as a modality of treating symptomatic lumbar disc disease due to DDD. However, longer term prospective studies are needed to prove this and to evaluate its role in the treatment of patients with CLDH.

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Section: Discussionmentioning

confidence: 99%

Annulo-nucleoplasty using Disc-FX in the management of lumbar disc pathology: Early results

Kumar

et al. 2014

Int J Spine Surg

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In-vivo T2-relaxation times of asymptomatic cervical intervertebral discs

et al. 2015

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Limited research exists on T2 mapping techniques for cervical intervertebral discs and its potential clinical utility. The objective of this research was to investigate the in-vivo T2 relaxation times of cervical discs, including C2-C3 through C7-T1. Ten asymptomatic subjects were imaged using a 3.0 T MR scanner and a sagittal multi-slice multi-echo sequence. Using the mid-sagittal image, intervertebral discs were divided into five regions-of-interest (ROIs), centered along the mid-line of the disc. Average T2 relaxation time values were calculated for each ROI using a mono-exponential fit. Differences in T2 values between disc levels and across ROIs of the same disc were examined. For a given ROI, the results showed a trend of increasing relaxation times moving down the spinal column, particularly in the middle regions (ROIs 2, 3 and 4). The C6-C7 and C7-T1 discs had significantly greater T2 values compared to superior discs (discs between C2 and C6). The results also showed spatial homogeneity of T2 values in the C3-C4, C4-C5, and C5-C6 discs, while C2-C3, C6-C7, and C7-T1 showed significant differences between ROIs. The findings indicate there may be inherent differences in T2 relaxation time properties between different cervical discs. Clinical evaluations utilizing T2 mapping techniques in the cervical spine may need to be level-dependent.

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One-year follow-up results of intradiscal diode laser, radiofrequency, and pulsed radiofrequency therapies: a retrospective study

Ökmen

2016

Lasers Med Sci

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This study aims to investigate the efficacy of three different percutaneous intradiscal therapies in patients with chronic low back pain (CLBP) due to lumbar disc herniation (LDH). Medical files of a total of 120 patients who received percutaneous intradiscal therapy were retrospectively analyzed. All patients were divided into three groups: group L: diode laser (n = 40), group R: radiofrequency (RF) (n = 40), and group P: pulsed radiofrequency (PRF) (n = 40). The visual analogue scale (VAS) and Oswestry Disability Index (ODI) scores were calculated at 1, 3, 6, and 12 months for all patients. One-year follow-up results were as follows: group L: pre-treatment (PreT) VAS 5.6 ± -1, ODI 37.6 ± -4.7, post-treatment 12th month (PT12) VAS 2.8 ± -1.4, ODI 14.1 ± -7.1; group P: PreT VAS 6.0 ± 1, ODI 37.5 ± 5.9, PT12 VAS 3.1 ± 1.3, ODI 20.3 ± 17.0; and group R: PreT VAS 5.6 ± 1.0, ODI 37.9 ± 4.7, PT12 VAS 3.3 ± 1.4, ODI 27.2 ± 14.1. In each of the three groups, there was a statistically significant reduction in the VAS and ODI scores at 1, 3, 6, and 12 months, compared to the baseline values (p < 0.05). The highest reduction in the VAS and ODI scores was observed in group L, whereas the lowest reduction was in group R. We consider that in groups with patient selection criteria at our study; diode laser, RF, and PRF, which are administered using the percutaneous intradiscal route for CLBP patients diagnosed with LDH, may be used as an alternative treatment option.

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Identification of intervertebral disc regeneration with magnetic resonance imaging after a long-term follow-up in patients treated with percutaneous diode laser nucleoplasty: a retrospective clinical and radiological analysis of 14 patients

Cited by 6 publications

References 26 publications

Annulo-nucleoplasty using Disc-FX in the management of lumbar disc pathology: Early results

Annulo-nucleoplasty using Disc-FX in the management of lumbar disc pathology: Early results

In-vivo T2-relaxation times of asymptomatic cervical intervertebral discs

One-year follow-up results of intradiscal diode laser, radiofrequency, and pulsed radiofrequency therapies: a retrospective study

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