Advertisement

Percutaneous Intervertebral Disc Coagulation Therapy (PDCT) by Plasma Light: Preliminary Data from the First Experience in Europe

  • Chiara Zini
  • Dario Notaro
  • Giulia Sadotti
  • Giacomo Zini
  • Lucia Monti
  • Matteo BelliniEmail author
Clinical Investigation Non-Vascular Interventions
  • 4 Downloads
Part of the following topical collections:
  1. Non-Vascular Interventions

Abstract

Purpose

To retrospectively assess safety and potential effectiveness of percutaneous intervertebral disc coagulation therapy (PDCT) using plasma thermal reaction for the treatment of lumbar and cervical disc hernias resistant to medical therapy.

Materials and Methods

Forty-four patients (age range 18–87 years, mean 52.7) with contained and extruded symptomatic lumbar (N = 48) and cervical (N = 6) disc hernias in the absence of free fragments causing radiculopathy without improvement after 6-week conservative therapy were enrolled. Pretreatment discography has been performed in every patient. Spine MRI was performed before the procedure and 4 months later, in order to check post-PDCT changes. Technical success was defined as correct placement of PDCT fiber; clinical outcomes were evaluated using visual analog scale (VAS) and the Oswestry Disability Index (ODI) before the procedure and after 4 months.

Results

A total of 54 levels have been treated with 98% technical success; in 12 patients (27%), the treatment was performed in two levels at the same time. All patients well tolerated the procedure; most patients (N = 39; 89%) had significant improvement in symptoms, with ODI score reduction from 47.61 ± 8.7 to 13.38 ± 9.4 (p < 0.001). The mean pre-PDCT VAS score was 7.47 ± 0.8. VAS score was decreased down to 1.36 ± 1.6 at final follow-up (p < 0.001). There were no cases of infection, nerve damage, or bleeding.

Conclusions

PDCT can be an effective and safe for minimally invasive indirect decompression for cervical and lumbar hernia resistant to conservative treatment, particularly when patients are correctly selected.

Keywords

Disc herniation PDCT Plasma light 

Notes

Acknowledgments

We thank Prof. Alessandro Rossi, chief of the Neurologic and Motor Sciences Department (“Santa Maria alle Scotte” University Hospital, Siena, Italy), for his invaluable help and comments.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Informed Consent

For the present study formal consent is not required; for this type of study informed consent is not required. Privacy consent was obtained for every individual person’s data included in the study; for this type of study consent for publication is not required.

References

  1. 1.
    Kaye AD, Manchikanti L, Abdi S, et al. Efficacy of epidural injections in managing chronic spinal pain: a best evidence synthesis. Pain Physician. 2015;18:E939–1004.Google Scholar
  2. 2.
    Kelekis AD, Filippiadis DK, Martin JB, Brountzos E. Standards of practice: quality assurance guidelines for percutaneous treatments of intervertebral discs. Cardiovasc Interv Radiol. 2010;33:909–13.CrossRefGoogle Scholar
  3. 3.
    Côté P, Cassidy JD, Carroll LJ, Kristman V. The annual incidence and course of neck pain in the general population: a population-based cohort study. Pain. 2004;112:267–73.CrossRefGoogle Scholar
  4. 4.
    Kreiner DS, Hwang SW, Easa JE, et al. An evidence-based clinical guideline for the diagnosis and treatment of lumbar disc herniation with radiculopathy. Spine J. 2014;14:180–91.CrossRefGoogle Scholar
  5. 5.
    German JV, Adamo MA, Hoppenot RG, Blossom JH, Nagle HA. Perioperative results following lumbar discectomy: comparison of minimally invasive discectomy and standard microdiscectomy. Neurosurg Focus. 2008;25:F20.CrossRefGoogle Scholar
  6. 6.
    Alò KM, Wright RE, Sutcliffe J, Brandt SA. Percutaneous lumbar discectomy: one-year follow-up in an initial cohort of fifty consecutive patients with chronic radicular pain. Pain Pract. 2005;5:116–24.CrossRefGoogle Scholar
  7. 7.
    Slipman CW, Bender FJ III, Menkin S, Garvan C, Salam A, Siegelman E. Percutaneous lumbar disk decompression using the dekompressor: a pilot study. Arch Phys Med Rehabil. 2006;87:e21.CrossRefGoogle Scholar
  8. 8.
    Galluci M, Limbucci N, Paonessa A, Splendiani A. Degenerative disease of the spine. Neuroimaging Clin N Am. 2007;17:87–103.CrossRefGoogle Scholar
  9. 9.
    Filippiadis DK, Kelekis A. A review of percutaneous techniques for low back pain and neuralgia: current trends in epidural infiltrations, intervertebral disk and facet joint therapies. Br J Radiol. 2016; 89:1057.CrossRefGoogle Scholar
  10. 10.
    Kim SH, Kim SC, Cho KH. Clinical outcomes of percutaneous plasma disc coagulation therapy for lumbar herniated disc disease. J Korean Neurosurg. 2012;51:8–13.CrossRefGoogle Scholar
  11. 11.
    Gerszten PC, Smuck M, Rathmell JP, et al. Bloch and the SPINE Study Group Plasma disc decompression compared with fluoroscopyguided transforaminal epidural steroid injections for symptomatic contained lumbar disc herniation:a prospective, randomized, controlled trial. J Neurosurg Spine 2015;12: 357– 371.CrossRefGoogle Scholar
  12. 12.
    Yucetas Seyho C, Gezgin Inan, Yildirim Can H, Ehi Yusuf, Kaya Miktat. Evaluation of long-term clinical results of percutaneous plasma disk coagulation treatment in lumbar and cervical disk herniation. Neurosurg Q. 2016;26:219–24.CrossRefGoogle Scholar
  13. 13.
    Kelekis A, Filippiadis DK. Percutaneous treatment of cervical and lumbar herniated disc. Eur J of Radiol. 2015;84:771–6.CrossRefGoogle Scholar
  14. 14.
    Moore Jeffrey A, Albert Todd J, Radcliff Kris. The value and cost-effectiveness of adult degenerative lumbar surgery. Semin Spine Surg. 2014;26:38–44.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2019

Authors and Affiliations

  • Chiara Zini
    • 2
  • Dario Notaro
    • 3
  • Giulia Sadotti
    • 3
  • Giacomo Zini
    • 4
  • Lucia Monti
    • 1
  • Matteo Bellini
    • 1
    Email author
  1. 1.Dipartimento di Scienze Neurologiche e Motorie, UOC Neuroimmagini e NeurointerventisticaAzienda Ospedaliera Universitaria SeneseSienaItaly
  2. 2.Azienda Toscana CentroOspedale di Santa Maria AnnunziataFirenzeItaly
  3. 3.Dipartimento di Scienze Mediche, Chirurgiche e NeuroscienzeUniversità degli Studi di Siena, Policlinico Santa Maria alle ScotteSienaItaly
  4. 4.Ingegneria Civile e AmbientaleUniversità degli Studi di FirenzeFirenzeItaly

Personalised recommendations