Intradiscal Pressure Study of Percutaneous Disc Decompression With Nucleoplasty in Human Cadavers

Chen, Yung-Chih; Lee, Sang heon; Chen, Darwin

doi:10.1097/01.brs.0000051920.45671.88

Cited by 103 publications

(85 citation statements)

References 19 publications

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“…In contrast, IDP change in healthy individuals moving from a flexion to an extension posture followed a quadratic relationship. Nucleus pressure was raised corresponding to increase in volume by the injection of fluid (Andersson and Schultz 1979;Ranu 1993) and fell when the volume was decreased by either surgical excision (Brinckmann and Grootenboer 1991) or nucleoplasty (Chen et al 2003). There was a reduction in the hydrostatic pressure in the functional nucleus of discs that were subjected to rigorous creep loading; 1-2 kN maintained for 2-3 h (Adams et al 1996).…”

Section: Introductionmentioning

confidence: 99%

The influence of exogenous cross-linking and compressive creep loading on intradiscal pressure

Chuang

Lin²,

Hedman

2010

Biomech Model Mechanobiol

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This study involves a biomechanical evaluation of a prospective injectable treatment for degenerative discs. The high osmolarity of the non-degenerated nucleus pulposus attracts water contributing to the hydrostatic behavior of the tissue. This intradiscal pressure is known to drop as fluid is exuded from the matrix due to compressive loading. The objective of this study was to compare the changes in intradiscal pressure in control and genipin cross-linked intervertebral discs. Thirty bovine lumbar motion segments were randomly divided into a phosphate-buffered saline control group and a 0.33% genipin group and soaked at room temperature for 2 days. A needle pressure sensor was held in the center of the disc while short-term and static creep compressive loads were applied. The control group demonstrated a 25% higher average intradiscal pressure compared to genipin-treated discs under 750 N compressive load (p=0.029). Depressurization during static compressive creep was 56% higher in the control than in the genipin group (p=0.014). These results suggest cross-linking induced changes in the poroelastic properties of the involved tissues affected the mechanics of compressive load support in the disc with lower levels of nucleus pressure, a corresponding decrease in the elastic expansion of the annulus, and an increased axial compressive loading of the inner and outer annulus tissues. It is possible that concurrent changes in hydraulic permeability and proteoglycan retention known to be associated with genipin cross-linking were also contributors to poroelastic changes. Reduction of peak pressures and moderation of pressure fluctuations could be beneficial relative to discogenic pain.

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Section: Introductionmentioning

confidence: 99%

The influence of exogenous cross-linking and compressive creep loading on intradiscal pressure

Chuang

Lin²,

Hedman

2010

Biomech Model Mechanobiol

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“…In the older, degenerative disk cadavers, the change in intradiscal pressure after nucleoplasty was very small. There was an inverse correlation between the degree of disk degeneration and the change of intradiscal pressure [10].…”

Section: Introductionmentioning

confidence: 84%

CT-Guided Nucleoplasty: Preliminary Experience

et al. 2009

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“…The effect of decreasing intradiscal pressure by nucleoplasty is still controversial. Chen et al demonstrated a noticeable reduction in disc pressure after using nucleoplasty in human cadavers, but there is still no irrefutable evidence in vivo [27]. A possible explanation of coblation effect may be the thermal effect of nucleoplasty.…”

Section: Discussionmentioning

confidence: 99%

The efficacy of coblation nucleoplasty for protrusion of lumbar intervertebral disc at a two-year follow-up

Zhu

Zhou

Cheng

et al. 2011

International Orthopaedics (SICOT)

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Purpose The purpose of this study was to evaluate longerterm efficacy over a two-year follow-up of coblation nucleoplasty treatment for protruded lumbar intervertebral disc. Methods Forty-two cases of protruded lumbar intervertebral disc treated by coblation nucleoplasty followed-up for two years were analysed. Relief of low back pain, leg pain and numbness after the operation were assessed by visual analogue pain scale (VAS). Function of lower limb and daily living of patients were evaluated by the Oswestry Disability Index (ODI). Results Operations were performed successfully in all cases. Three patients had recurrence within a week of the procedure. Evaluation of the 42 patients demonstrated significant improvement rate of VAS: defined as 66.2% in back pain, 68.1% in leg pain, and 85.7% in numbness at one-week after the operation; 53.2%, 58.4%, 81.0% at oneyear; and 45.5%, 50.7%, 75.0% at two-year follow-up. One week after the operation, obvious amelioration occurred in all the patients, but the tendency decreased. Before operation, the mean value of ODI was 68.2±10.9%. The value at one week was 28.6±8.2%; one-year at 35.8±6.5%; and two-years at 39.4±5.8%. Conclusion Coblation nucleoplasty may have satisfactory clinical outcomes for treatment of protruded lumbar intervertebral disc for as long as two-year follow-up, but longer-term benefit still needs verification.

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Intradiscal Pressure Study of Percutaneous Disc Decompression With Nucleoplasty in Human Cadavers

Abstract: Pressure reduction through nucleoplasty is highly dependent on the degree of spine degeneration. Nucleoplasty markedly reduced intradiscal pressure in nondegenerative discs, but had a negligible effect on highly degenerative discs.

Cited by 103 publications

References 19 publications

The influence of exogenous cross-linking and compressive creep loading on intradiscal pressure

The influence of exogenous cross-linking and compressive creep loading on intradiscal pressure

CT-Guided Nucleoplasty: Preliminary Experience

The efficacy of coblation nucleoplasty for protrusion of lumbar intervertebral disc at a two-year follow-up

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