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Percutaneous Intervertebral Disc Coagulation Therapy (Pdct) By Plasma Light: A New Method For The Treatment Of Lumbar And Cervical Disc Herniations, Preliminary Experience 2014

Category Interventional Matteo Bellini, MD Daniele Giuseppe Romano, MD Marco Ferrara, MD Irene Grazzini, MD Sandra Bracco, MD Lucia Monti, MD Alfonso Cerase, MD Purpose To assess safety and potential effectiveness of percutaneous intervertebral disc coagulation therapy based on plasma thermal reaction (PDCT) for the treatment of lumbar and cervical disc herniations. We present the apparatus, operative procedure, advantages of this procedure and early results. Materials & Methods This study included 18 patients (age range: 18-77 years, mean: 53,6), affected by contained symptomatic lumbar (n.19) and cervical (n.5) disc herniations. Inclusion criteria were contained lumbar or cervical herniations causing radiculopathy without improvement after 6-week conservative therapy. Spinal MRI was performed before the procedure and 3 months later, in order to check post-PDCT changes. Clinical outcomes were evaluated using Visual Analog Scale (VAS) before procedure and 3 months later. In 7 patients, the treatment was performed in 2 levels at the same time. The PDCT system (PLASMA D30, Jeisys Corporation, Seoul, South Korea) is equipped with a diode laser module and 0.4 cm plasma optical fiber. All treatments were performed under fluoroscopic guidance (Innova 3131iq, General Electric Healthcare, CT, USA), with local anesthesia (5ml subcutaneous lidocaine), and standard anti-infectious therapy. Pre-treatment discography has been performed in all the patients. Plasma fiber has been directed toward 2 points of the nucleus pulposus and near to the annulus fibrosus. Results All the patients tolerated well the procedure. At the application of plasma fiber close to the annulus, 10 patients referred mild pain or heartburn, which disappeared immediately after treatment. There were no cases of infection, nerve damage, nor bleeding. Most patients (n: 15) had significant improvement in symptoms with relevant post-operative VAS scale reduction (p Conclusion As a minimally-invasive indirect decompression methods, PDCT can be effective, safe and convenient when patients are correctly selected. Further studies on PDCT in comparison with other previously known procedures are needed. References Sang Hyun Kim et al. Clinical Outcomes of Percutaneous Plasma Disc Coagulation Therapy for Lumbar Herniated Disc. J Korean Neurosurg Soc. 2012 Jan;51(1):8-13. English.