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