Introduction
In the treatment of spinal conditions, the dependability and practicality of medical devices are essential. The case report by Dr. Fabrizio Fasoli and Dr. Fabrizio Vecchietti from Ospedale CTO Andrea Alesini, ASL ROMA 2, in Rome, Italy, illustrates how DISKOM™ has effectively supported percutaneous discectomy procedures, providing a reliable solution for patients with lumbar disc herniation.
Patient History
The case involves a 55-year-old man suffering from progressive low back and limb pain for over three months, unresponsive to conservative therapy. Clinical evaluation revealed pain in the lower back and limbs, with no neurological deficits, confirmed by a positive clinical test.
Pre-Operative Information
Pre-operative MRI indicated a contained lumbar disc herniation at L4-L5, causing nerve root conflict and associated radiculopathy. The MRI scans confirmed the presence of the herniation and its impact on the emerging nerve root. Pain perception was measured using a Visual Analog Scale (VAS), showing a significant reduction in pain by approximately 5 points and an 87% subjective improvement post-treatment.
Interventional Strategy
The DISKOM™ procedure involved precise disc puncture, performed just lateral to the articular process to avoid the extraforaminal nerve root. Using fluoroscopic guidance, the C-arm fluoroscope identified the entry point at the articular process level. The needle placement was confirmed through anteroposterior and lateral fluoroscopic projections.
After the stylet removal, a probe was introduced into the cannula and activated. The probe advanced 1 cm while performing a turning manoeuvre for 2-3 minutes, enabling partial removal of the nucleus pulposus. Typically, five nucleo-aspirations are performed before removing the device.
Results
Twelve months post-treatment, MRI analysis revealed a significant reduction in lumbar disc herniation, correlating with a marked improvement in pain. The procedure’s efficacy is evident in the sustained pain relief and functional improvement reported by the patient.
Advantages of DISKOM™
- Precision and Safety: The reliable design of DISKOM™ ensures precise needle placement and controlled nucleus aspiration, minimizing risks and complications.
- Minimally Invasive Approach: The procedure, performed under local anaesthesia with constant fluoroscopic control, is minimally invasive, allowing for outpatient or day hospital settings.
- Effective Pain Relief: The technique provides significant pain relief for patients with contained lumbar disc herniation, improving their quality of life.
Conclusion
The case report by Dr. Fasoli and Dr. Vecchietti demonstrates that DISKOM™ is a dependable and functional solution for percutaneous discectomy. The system’s reliable design and methodical approach have resulted in excellent patient outcomes, establishing a robust treatment option for lumbar disc herniation.
For healthcare professionals and stakeholders in spinal health, the findings from this single-centre experience highlight the potential of DISKOM™ in transforming discectomy procedures, ensuring better patient care and enhanced procedural success.
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