Long Term Clinical Results in Laser Reconstruction of Spine Discs

Басков, А В; Borshchenko, Igor; Shekhter, Anatoly B.; Baskov, V. A.; Guller, Anna; Sobol, Emil N.

doi:10.4172/2165-7939.1000210

Cited by 5 publications

(4 citation statements)

References 26 publications

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“…The added advantage was that the patients involved in our study had a shorter recovery time, allowing them to return to normal duties within a few days. This observation was also in line with the conclusion by Gronemeyer et al and Baskov et al , which recorded favorable outcomes after PLDD procedure.…”

Section: Discussionsupporting

confidence: 92%

CT‐Guided Percutaneous Laser Disc Decompression for Lumbar Discogenic Radiculopathy‐Performance of a Novel Combi‐Therapy

Frimpong

Aboagye²,

Frimpong³

et al. 2019

Lasers Surg Med

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Background and Objectives On the basis of reported immediate and short‐term excruciating pain by patients in the post‐procedural period of computed tomography (CT)‐guided percutaneous laser disc decompression (PLDD) in our clinic, we present our initial clinical experience with a novel combi‐therapy using a combination of CT‐guided PLDD and CT‐guided epidural nerve blocks, which proved effective in managing the pain. Study Design/Materials and Methods A total of 100 patients who met the criteria for PLDD, underwent treatment for lumbar discogenic radiculopathy between 2014 and 2017. Fifty‐five percent of the patients were males and 45% were females with a mean age of 46.25 years. Ninety‐five patients underwent one level PLDD and five patients two‐level PLDD procedures. CT‐guided epidural nerve block with a combination of Bupivacaine, Lignocaine, and Kenalog was used in a 3× procedure separated by a 1‐week interval. The first nerve block was given the same day, immediately after the PLDD procedure. The visual analogue scale (VAS) for pain was used during the pre‐procedure and post‐procedure periods. Results Among the patients who underwent one level PLDD, 88 had L4–L5 levels, 5 had L5–S1 levels and 2 had L3–L4 levels. L4–L5 and L5–S1 levels were the most common two‐level PLDD locations in seven patients. Five patients in our study subsequently underwent open surgical treatment. All patients reported immediate pain relief, which was sustained after the procedure. The average pre‐procedure VAS score was 7.6 (range from 5 to 8.2) and the VAS score immediately after the procedure was on average 0.5 (ranging from 0 to 2). Conclusions Findings from this initial experience using a combi‐therapy of CT‐guided PLDD and CT‐guided epidural nerve block have shown the benefits of this novel approach, offering significant immediate pain relief in the post‐procedural phase, favorable outcomes in the short to mid‐term and a significantly reduced rate of re‐surgery (7%) compared with the use of only CT‐guided PLDD. Lasers Surg Med 00:1–5, 2019. © 2019 Wiley Periodicals, Inc.

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Section: Discussionsupporting

confidence: 92%

CT‐Guided Percutaneous Laser Disc Decompression for Lumbar Discogenic Radiculopathy‐Performance of a Novel Combi‐Therapy

Frimpong

Aboagye²,

Frimpong³

et al. 2019

Lasers Surg Med

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“…Irradiation was performed through 600 μm fiber of infrared laser with λ = 1560 nm described in Section 2.2 positioning in the center of the cell. Three laser modes were tested: (IR-5.5)-the low-level laser mode of probe radiation of 5.5 W/cm 2 (photo-control) given in Section 2.2 for the measurements of optical transmittance, the air gap between emitting fiber and liquid surface was equal to that from fiber to cartilage used in 2.2 (0.7 cm), the total square of the cell (0.5 cm 2 ) was irradiated; (IR-350)the high energy mode used in laser surgery [18,19]: power density 350 W/cm 2 pulse duration 2 seconds, pause between pulses 1 seconds, time of irradiation 20 seconds, no air gap between emitting fiber and liquid, irradiated square 0.003 cm 2 ; (IR-530)-the mode of 50% higher energy than (IR-350) (thermal-control) described in [21] for experimental analysis of transparency of nucleus pulposus under irradiation: power density 530 W/cm 2 , pulse duration 2 seconds, pause between pulses 1 seconds, time of irradiation 20 seconds, no air gap between emitting fiber and liquid, irradiated square 0.003 cm 2 . Raman spectra were measured immediately after irradiation.…”

Section: Raman Spectroscopymentioning

confidence: 99%

“…In some cases like cartilage reshaping the needed temperature for stress relaxation may exceed the equilibrium denaturation temperature, however, at short pulses the tissue cooling is much faster than the phase transformation has time to occur. For laser regeneration of cartilage that is used for the treatment of joint cartilage [18,20,41] and spinal disc [18,19] the working temperature usually does not exceed 45 C to 50 C [20,41]. The method of laser reshaping of cartilage is used for correction of nasal septum deformities [41] and preparation of semicircle costal cartilage implants in trachea surgery [7,40].…”

Section: Raman Spectroscopymentioning

confidence: 99%

“…Iohexol solution is allowed for medical application and originally presents a kind of iodinated contrast media widely used in radiography of internal organs [12], intravascular monitoring [13,14], tumor metastases detection [15] and contrast enhanced cartilage visualization [16,17] including procedures where IR irradiation is carried out such as laser reconstruction of interverbal disc [18][19][20][21]. Additionally, it was shown as effective OCA for hyaline-type cartilage in visible and infrared spectral range near water transparency window [22,23].…”

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confidence: 99%

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Control of optical transparency and infrared laser heating of costal cartilage via injection of iohexol

Alexandrovskaya

Evtushenko

Obrezkova

et al. 2018

Journal of Biophotonics

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Infrared (IR) laser impact has no analogues for rapid and safe cartilage reshaping. For better penetration of radiation optical clearing agents (OCAs) can be applied. In present work, the effect of low-osmolality agent iohexol on costal cartilage is studied. Specifically, it is shown that ½ of total increase of optical transparency occurs in 20 minutes of immersion. Maximally, cartilage transparency on 1560 nm can be increased in 1.5 times. Injection of iohexol results in increased tissue hygroscopicity, lower drying rate and higher percentage of bound water. Effective diffusion coefficients of water liberation at 21°C are (5.3 ± 0.4) × 10 and (3.3 ± 0.1) × 10 cm /s for untreated and iohexol-modified tissue, respectively. Raman spectroscopy of irradiated iohexol solution reveals its photo and thermo-stability under clinically used IR laser energies up to 350 W/cm for exposure times of several seconds. At energies higher than 500 W/cm [Correction added on 5 September 2018, after first online publication: This unit has been changed] decomposition of iohexol occurs rapidly through formation of molecular iodine and fluorescent residue.

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Biological non-ablative repair of lumbar discs by transforaminal intradiscal laser irradiation: MRI quantitative analysis of the effects—preliminary report

et al. 2020

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Long Term Clinical Results in Laser Reconstruction of Spine Discs

Cited by 5 publications

References 26 publications

CT‐Guided Percutaneous Laser Disc Decompression for Lumbar Discogenic Radiculopathy‐Performance of a Novel Combi‐Therapy

CT‐Guided Percutaneous Laser Disc Decompression for Lumbar Discogenic Radiculopathy‐Performance of a Novel Combi‐Therapy

Control of optical transparency and infrared laser heating of costal cartilage via injection of iohexol

Biological non-ablative repair of lumbar discs by transforaminal intradiscal laser irradiation: MRI quantitative analysis of the effects—preliminary report

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