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Extensive damage to the end-plates as a complication of laser discectomy an experimental study using an animal model

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Summary

To date, there have been no reports of experiments demonstrating the effects of neodymium:YAG laser (Nd∶YAG laser) on the vertebral end-plates. In this study the effect of Nd∶YAG laser on end-plates was examined in 32 guinea pigs which were randomly divided into two groups. The first group was the control group, the second one the Nd∶YAG laser group. All animals had experimental disc degeneration at three levels. Re-exploration was performed two months after the surgical ventral disc herniation. In the second group the same procedure was performed but at the end of the reexploration, Nd∶YAG laser irradiation of the degenerated discs was done. The wounds in both groups were closed again. Two months later all animals were sacrificed for histological and biochemical analysis. The cervical spine was excised en bloc and the overlying muscles were removed. Determination of hydroxyproline was done colorimetrically in the specimens harvested from each of these groups. Light microscopy was undertaken to evaluate the extent of morphological changes. The differences observed between the two groups were statistically significant (p<0.05). From the results of this study, there is the question whether the Nd∶YAG laser is a useful instrument in neurosurgery. Therefore, it remains to be proven whether or not this is of real benefit in the treatment of patients with degenerated disc disease.

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References

  1. Açikgöz B, Turgut M, Özcan OE, Özgen T, Demirhan B, Ruacan S (1992) Delay of cranial bone regeneration by CC2 and Nd∶YAG laser application: an experimental study related to craniosynostosis. Lasers Med Sci 7: 49–53

    Google Scholar 

  2. Aguila LA, Piraino DW, Modic MT, Dudley AW, Duchesneau PM, Weinstein MA (1985) The intranuclear cleft of the intervertebral disc: magnetic resonance imaging. Radiology 155: 155–158

    PubMed  Google Scholar 

  3. Artigas J, Brock M, Mayer H-M (1984) Complications following chemonucleolysis with collagenase. J Neurosurg 61: 679–685

    PubMed  Google Scholar 

  4. Ascher PW, Choy DSJ, Yuri H (1989) Percutaneous nucleus pulposus denaturation and vaporization of protruded discs. Am Soc Laser Med Surg Abstracts [Suppl] 1: 202

    Google Scholar 

  5. Bağdatoğlu H, Ildan F, Qöçer AI, Güleryüz A, Uzuneyüpoğlu Z, Haciyakupoğlu S (1994) Denaturation of the nucleus pulposus with the Nd∶YAG laser in animal model. Ann Med Sci 3: 45–51

    Google Scholar 

  6. Beck OJ (1984) Use of the Nd∶YAG laser in neurosurgery. Neurosurg Rev 7: 151–158

    PubMed  Google Scholar 

  7. Beck OJ, Wilske J, Schonberger JL, Gorish W (1979) Tissue changes following application of laser to the rabbit brain. Neurosurg Rev 1: 31–36

    Google Scholar 

  8. Bergman I, Loxley R (1963) Two improved and simplified methods for the spectrophotometric determination of hydroxiproline. Anal Chem 35: 1961–1965

    Google Scholar 

  9. Bernhard M, Gurganious LR, Bloom PL, White AA (1993) Magnetic resonance imaging analysis of percutaneous discectomy. Spine 18: 211–217

    PubMed  Google Scholar 

  10. Bernick S, Cailliet R (1982) Vertebral end-plate changes with ageing of human vertebrae. Spine 7: 97–102

    PubMed  Google Scholar 

  11. Brock M, Gorge H, Curio G (1984) Intradiscal pressure-volume response: a methodological contribution to chemonucleolysis. J Neurosurg 60: 1029–1032

    PubMed  Google Scholar 

  12. Buchelt M, Kutschera HP, Katterschafka T, Kiss H, Schneider B, Ulrich R (1992) Erb∶YAG and Hol∶YAG laser ablation of meniscus and intervertebral discs. Lasers Surg Med 12: 375–381

    PubMed  Google Scholar 

  13. Choy DSJ (1992) Risks of laser discolysis (letter). J Neurosurg 77: 978

    PubMed  Google Scholar 

  14. Choy DSJ, Ascher PW, Saddekni S, Alkaitis D, Liebler W, Hughes J, Diwan S, Altman P (1992) Percutaneous laser disc decompression. A new therapeutic modality. Spine 17: 949–956

    PubMed  Google Scholar 

  15. Choy DSJ, Case RB, Fielding W, Hughes J, Liebler W, Ascher P (1987) Percutaneous laser nucleolysis of lumbar disks. N Engl J Med317: 771–772

    PubMed  Google Scholar 

  16. Coventry MB, Ghormley RK, Kernohan JW (1945) The intervertebral disc: its microscopic anatomy and pathology. I. The anatomy, development and physiology. J Bone Joint Surg 27A: 105–112

    Google Scholar 

  17. Cummins L (1983) Thermal effects of laser radiation in biological tissue. Biophys J 42: 99–102

    PubMed  Google Scholar 

  18. Edwards MSB, Boggan JE, Fuller TA (1983) The laser in neurological surgery. J Neurosurg 59: 555–566

    PubMed  Google Scholar 

  19. Eyring EJ (1969) The biochemistry and physiology of the intervertebral disk. Clin Orthop 67: 16–28

    PubMed  Google Scholar 

  20. Gropper GR, Robertson JH, McClellan G (1984) Comparative histological and radiographic effects of CO2 laser versus standard surgical anterior cervical discectomy in the dog. Neurosurgery 14: 42–47

    PubMed  Google Scholar 

  21. Guinn NJ (1993) Percutaneous laser discectomy. An alternative method. Todays OR Nurse 15: 9–12

    Google Scholar 

  22. Güner M, Acar Ü, Mertol T, Uçar E, Ösün A (1992) Perkutan automated lumbal diskektomi. Türk Nöroşirürji Dergisi Ek 5: 187

    Google Scholar 

  23. Hall DA (1987) Structure and function of the ageing intervertebral disc. In: Hukins DWL, Nelson MA (eds) The ageing spine. Manchester University Press, Manchester, pp 40–60

    Google Scholar 

  24. Higuch M, Kaneda K, Abe K (1982) Postnatal histogenesis of the cartilage plate of the spinal column. Spine 7: 89–96

    PubMed  Google Scholar 

  25. Hilton RC, Ball J, Benn RT (1976) Vertebral end plate lesions in the dorso-lumbar spine. Ann Rheum Dis 35: 127–132

    PubMed  Google Scholar 

  26. Holm S (1993) Pathophysiology of disc degeneration. Acta Orthop Scand 64: 13–15

    PubMed  Google Scholar 

  27. Hudgins WR, Jacques DS (1985) The laser in microneurosurgery. In: Rand R (ed) Microneurosurgery. Mosby, St. Louis, pp 49–61

    Google Scholar 

  28. Humzah MD, Soames RW (1988) Human intervertebral disc: structure and function. Anat Rec 220: 337–356

    PubMed  Google Scholar 

  29. Inoue H (1981) Three dimensional architecture of lumbar intervertebral discs. Spine 6: 139–146

    PubMed  Google Scholar 

  30. Jolesz FA, Bleier AR, Jakob P, Ruenzel PW, Huttl K, Jako GJ (1988) MR imaging of laser-tissue interactions. Radiology 168: 249–253

    PubMed  Google Scholar 

  31. Key JA, Ford LT (1948) Experimental intervertebral disc lesions. J Bone Joint Surg 30 A: 621–630

    Google Scholar 

  32. Kirkaldy-Willis WH, Dupuis PR, Yong-Hing K (1990) Biomechanics and aging of the spine. In: Youmans JR (ed) Neurological surgery, vol 4. Saunders, Philadelphia, pp 2605–2628

    Google Scholar 

  33. Lavyne MH (1992) Complications of percutaneous laser nucleolysis. J Neurosurg 76: 1041

    Google Scholar 

  34. Mayer HM, Brock M, Berline HP, Weber B (1992) Percutaneous endoscopic laser disectomy (PELD) — a new surgical technique for non-sequestrated lumbar discs. Acta Neurochir (Wien) [Suppl 54]: 53–58

    Google Scholar 

  35. Mayer HM, Müller G, Schwetlick G (1993) Lasers in percutaneous disc surgery. Acta Orthop Scand [Suppl 251] 64: 38–44

    Google Scholar 

  36. McFadden KD, Taylor JR (1989) End plate lesions of the lumbar spine. Spine 14: 867–869

    PubMed  Google Scholar 

  37. Meyers AD, Denver MBA (1990) Lasers and wound healing. Arch Otolaryngol Head Neck Surg 116: 1128

    PubMed  Google Scholar 

  38. Modic MT, Pavlicek W, Weinstein MA, Boumphrey F, Ngo F, Hardy R, Duchesneau P (1984) Magnetic resonance imaging of intervertebral disk disease. Radiology 152: 103–111

    PubMed  Google Scholar 

  39. Oda J, Tanaka H, Tsuzuki N (1988) Intervertebral disc changes with ageing of human cervical vertebrae. Spine 13: 1205–1211

    PubMed  Google Scholar 

  40. Ohnmeiss DD, Guyer RD, Hochschuler SH (1994) Laser disc decompression. The importance of proper patient selection. Spine 19: 2054–2059

    PubMed  Google Scholar 

  41. Quigley MR, Maroon JC, Shih T, Elrifai A, Lesiecki ML (1994) Laser disectomy: comparison of systems. Spine 19: 319–322

    PubMed  Google Scholar 

  42. Quigley MR, Shih T, Elrifai A, Loesch D, Smith K, Lesiecki M, Maroon JC (1991) Laser disectomy: comparison of Ho∶YAG and Nd∶YAG systems. Surg Forum: 507–509

  43. Resnick D (1985) Degenerative diseases of the vertebral column. Radiology 156: 3–14

    PubMed  Google Scholar 

  44. Roberts S, Menage J, Urban JPG (1989) Biochemical and structural properties of the cartilage end-plate and its relation to the intervertebral disc. Spine 14: 166–173

    PubMed  Google Scholar 

  45. Saunders JB, Innman VT (1940) Pathology of the intervertebral disk. Arch Surg 40: 389–416

    Google Scholar 

  46. Smith JW, Walmsley R (1951) Experimental incision of the intervertebral disc. J Bone Joint Surg 33B: 612–625

    Google Scholar 

  47. Trauner K, Nishioka N, Patel D (1990) Pulsed holmium:yttrium-aluminum-garnet (Ho∶YAG) laser ablation of fibrocartilage and articular cartilage. Am J Sport Med 18: 316–320

    Google Scholar 

  48. Turgut M, Açikgöz B, Kilinç K, Özcan OE, Erbengi A (1996) Effect of Nd∶YAG laser on experimental disc degeneration. I. Biochemical and radiographical analysis. Acta Neurochir (Wien) 138 (11): 1348–1354

    Google Scholar 

  49. Turgut M, Özcan OE, Sungur A, Sargin H (1996) Effect of Nd∶YAG laser on experimental disc degeneration. II. Histological and MRI findings. Acta Neurochir (Wien) 138(11): 1355–1361

    Google Scholar 

  50. Walter GF, Ascher PW, Ingolitsch E (1984) The effects of carbon dioxide and neodymium-YAG laser on the central and peripheral nervous systems, and cerebral blood vessels. J Neurol Neurosurg Psychiatry 47: 745–749

    PubMed  Google Scholar 

  51. Wharen RE, Anderson RE, Scheithauer B, Sundt TM Jr (1984) The Nd∶YAG laser in neurosurgery. Part 1. Laboratory investigations: dose-related biological response of neural tissue. J Neurosurg 60: 531–539

    PubMed  Google Scholar 

  52. Wirth FP, Downing EF, Cannon CL, Baker RP (1987) Experience with the Neodymium:Yttrium-Garnet laser in forty-two cases. Neurosurgery 21: 867–871

    PubMed  Google Scholar 

  53. Yonezawa T, Onomura T, Kosaka R, Miyaji Y, Tanaka S, Watanabe H, Abe Y, Imachi K, Atumi K, Chinzei T, Mabuchi K, Fujimasa I (1990) The system and procedures of percutaneous intradiscal laser nucleotomy. Spine 15: 1175–1185

    PubMed  Google Scholar 

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We regret to report that Dr. Önol died after this article was submitted for publication.

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Turgut, M., Önol, B., Kilinç, K. et al. Extensive damage to the end-plates as a complication of laser discectomy an experimental study using an animal model. Acta neurochir 139, 404–410 (1997). https://doi.org/10.1007/BF01808875

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